Ring, Alexander;
Grob, Björn;
Aerts, Erik;
Ritter, Katharina;
Volbracht, Jörk;
Schär, Bettina;
Greiling, Michael;
Müller, Antonia M. S.
Resource utilization for chimeric antigen receptor T cell therapy versus autologous hematopoietic cell transplantation in patients with B cell lymphoma
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Media type:
E-Article
Title:
Resource utilization for chimeric antigen receptor T cell therapy versus autologous hematopoietic cell transplantation in patients with B cell lymphoma
Contributor:
Ring, Alexander;
Grob, Björn;
Aerts, Erik;
Ritter, Katharina;
Volbracht, Jörk;
Schär, Bettina;
Greiling, Michael;
Müller, Antonia M. S.
imprint:
Springer Science and Business Media LLC, 2022
Description:
<jats:title>Abstract</jats:title><jats:p>CD19-directed chimeric antigen receptor T cells (CAR-T) have emerged as a highly efficacious treatment for patients with relapsed/refractory (r/r) B cell lymphoma (BCL). The value of CAR-T for these patients is indisputable, but one-off production costs are high, and little is known about the ancillary resource consumption associated with CAR-T treatment. Here, we compared the resource use and costs of CAR-T treatment with high-dose chemotherapy followed by autologous stem cell transplantation (ASCT) for patients with r/r BCL. Standard operating procedures were used to develop a process model in ClipMed<jats:sup>PPM</jats:sup>, which comprises all activities and processes to sustain or generate treatment components that together constitute a treatment path. The software allows a graphic representation and the use of standardized linguistic elements for comparison of different treatment paths. Detailed processes involved in CAR-T treatments (<jats:italic>n</jats:italic> = 1041 processes) and in ASCT (<jats:italic>n</jats:italic> = 1535) were analyzed for time consumption of treatment phases and personnel. Process costs were calculated using financial controlling data. CAR-T treatment required ~ 30% less staff time than ASCT (primarily nursing staff) due to fewer chemotherapy cycles, less outpatient visits, and shorter hospital stays. For CAR-T, production costs were ~ 8 × higher, but overall treatment time was shorter compared with ASCT (30 vs 48 days), and direct labor and overhead costs were 40% and 10% lower, respectively. Excluding high product costs, CAR-T uses fewer hospital resources than ASCT for r/r BCL. Fewer hospital days for CAR-T compared to ASCT treatment and the conservation of hospital resources are beneficial to patients and the healthcare system.</jats:p>