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Research Letter
July 2018

Total Costs of Chimeric Antigen Receptor T-Cell Immunotherapy

Author Affiliations
  • 1Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, Pittsburgh, Pennsylvania
  • 2Center for Pharmaceutical Policy and Prescribing, University of Pittsburgh, Pittsburgh, Pennsylvania
  • 3Division of Hematology Oncology, Knight Cancer Institute, Oregon Health & Science University, Portland
  • 4Department of Public Health and Preventive Medicine, Oregon Health & Science University, Portland
  • 5Center for Health Care Ethics, Oregon Health & Science University, Portland
  • 6Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
JAMA Oncol. 2018;4(7):994-996. doi:10.1001/jamaoncol.2018.0977

In 2017, the US Food and Drug Administration approved the drugs tisagenlecleucel (Kymriah; Novartis) and axicabtagene ciloleucel (Yescarta; Kite Pharma) as the first chimeric antigen receptor T-cell (CAR-T) immunotherapies. Treatment with tisagenlecleucel has been priced at $475 000 and axicabtagene ciloleucel at $373 000; however, these prices are for the drug products alone and do not account for the costs associated with leukapheresis, lymphodepletion therapy, and the adverse effects of CAR-T immunotherapy. These costs are not negligible as 43 patients (44%) who received tisagenlecleucel in clinical trials required stays in the intensive care unit for cytokine release syndrome (CRS).1 In this study, we estimated the total costs of CAR-T immunotherapy, including nondrug costs, using publicly available data.

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