抗 CD19 CAR-T 细胞输注的住院给法国国家医疗保险带来多少费用

Chimeric antigen receptor T-cells (CAR-T cells) have the potential to be a major innovation as a new type of cancer treatment, but are associated with extremely high prices and a high level of uncertainty.

This study aims to assess the cost of the hospital stay for the administration of anti-CD19 CAR-T cells in France. Data were collected from the French Medical Information Systems Program (PMSI) and all hospital stays associated with an administrated drug encoded 9439938 (tisagenlecleucel, Kymriah ) or 9440456 (axicabtagene ciloleucel, Yescarta ) between January 2019 and December 2020 were included. 485 hospital stays associated with an injection of anti-CD19 CAR-T cells were identified, of which 44 (9%), 139 (28. 7%), and 302 (62.

3%) were for tisagenlecleucel in acute lymphoblastic leukaemia (ALL), tisagenlecleucel in diffuse large B-cell lymphoma (DLBCL), and axicabtagene ciloleucel respectively. The lengths of the stays were 37. 9, 23. 8, and 25. 9 days for tisagenlecleucel in ALL, tisagenlecleucel in DLBCL, and axicabtagene ciloleucel, respectively.

The mean costs per hospital stay were 372,400 for a tisagenlecleucel in ALL, 342,903 for tisagenlecleucel in DLBCL, and 366,562 for axicabtagene ciloleucel. CAR T-cells represented more than 80% of these costs. n=13 hospitals performed CAR-T cell injections, with two hospitals accounting for more than 50% of the total number of injections.

This study provides original data in a context of limited information regarding the costs of hospitalization for patients undergoing CAR-T cell treatments.

In addition to the financial burden, distance may also be an important barrier for accessing CAR T-cell treatment.