Healthcare cost and utilization for chimeric antigen receptor (CAR) T‐cell therapy in the treatment of pediatric acute lymphoblastic leukemia: A commercial insurance claims database analysis

• Published in: Cancer reports Vol. 7; no. 2; pp. e1980 - n/a
• Main Authors: Hoover, Alex, Reimche, Paige, Watson, Dave, Tanner, Lynn, Gilchrist, Laura, Finch, Mike, Messinger, Yoav H., Turcotte, Lucie M.
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.02.2024; Wiley
• Subjects: Adolescent; Age; Aged; ALL; Antigens; CAR‐T; Cell- and Tissue-Based Therapy; Child; Codes; cost; FDA approval; Female; Health Care Costs; Hospitals; Humans; Insurance claims; Insurance Coverage; Leukemia; Male; Outpatient care facilities; pediatric; Pediatrics; Pharmacy; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma; Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy; Receptors, Antigen, T-Cell; Receptors, Chimeric Antigen; Reimbursement; United States - epidemiology; Young adults; United States; United States > US; ALL; cost; CAR-T; pediatric
• ISSN: 2573-8348; 2573-8348
• DOI: 10.1002/cnr2.1980

Background B‐lineage acute lymphoblastic leukemia (B‐ALL) is the most common malignancy of childhood. With the introduction of novel cellular therapies, cost of care is a critical component and the financial burden experienced by patients and society requires evaluation. Aims This study aims to assess the utilization and cost of care for chimeric antigen receptor T‐cell (CAR‐T) therapy for pediatric ALL patients with commercial insurance coverage in the United States. Methods and Results Using de‐identified commercial insurance data from the OptumLabs® Data Warehouse, a cohort of 37 patients, aged 1‐25 years, with B‐ALL treated with CAR‐T therapy between Oct 2016 and Dec 2021 in the United States was identified. Cost was evaluated for a 90 day period encompassing CAR‐T infusion and by administration and complication characteristics. Among the 37 identified B‐ALL patients that received a CAR‐T product infusion, 14 patients were female, median age at administration was 13 years. The median 90‐day total cost was $620,500 (Mean: $589,108). Inpatient cost accounted for approximately 71% of the total cost with an average of 28 inpatient days per patient. Although inpatient cost was slightly higher in the older age group (aged 10‐25 years) and in patients with a code for cytokine release syndrome (CRS), these differences were not statistically significant. Conclusion This real‐world cost analysis shows for the first time the encompassing cost of CAR‐T therapy for pediatric B‐ALL patients in the US with commercial insurance. This study provides a valuable benchmark that can be used to analyze the financial implications of CAR‐T therapy for pediatric B‐ALL therapy on health systems.