Digital KOLs of #ASH23
The Digital KOLs of #ASH23
2 min read
Brian Shields : Dec 6, 2023 8:20:51 AM
A new study conducted by Dr. Amar Kelkar, of Dana-Farber Cancer Institute, and co-authors, recently published in the Annals of Internal Medicine, has analyzed the cost-effectiveness of using CAR-T therapy in Diffuse Large B-Cell Lymphoma (DLBCL) treatment. Amidst reactions to the research findings, a prevailing concern expressed by a number of notable medical personalities points to the dubious cost-effectiveness of the treatment in this setting.
A new study in @AnnalsofIM, led by Amar Kelkar, MD, MPH, (@amarkelkar) @DanaFarber, found #CART is not cost-effective as second-line therapy for diffuse large B-cell lymphoma at current prices.
β Dana-Farber News (@DanaFarberNews) December 4, 2023
Study: https://t.co/XPjCT0iMil
Read more: https://t.co/Q4j4vZBFHa pic.twitter.com/1bvyv7jTzO
Dr. Amar Kelkar, the lead author of the research, summarized the findings via his tweet thread and highlighted that "CAR-T, a therapy that costs almost 3x ASCT, but only improves survival by 1-4 months, is NOT COST-EFFECTIVE.". Dr. Kelkar also amused the Physician readers with his effective and humorous use of Social Media Memes to stress his points.
π₯Today in @AnnalsofIM: We show Axi-cel & Liso-cel are NOT COST-EFFECTIVE in our decision analysis of second-line CAR-T therapies for Diffuse Large B-Cell Lymphoma, and calculate the economic impact to be >$6.8 billion over 5 years!
β Amar Kelkar, MD, MPH, FACP (@amarkelkar) December 5, 2023
π§΅πhttps://t.co/9fYyJFdTfH pic.twitter.com/Bk3yYz8ozN
13/ In summary, CAR-T, a therapy that costs almost 3x ASCT, but only improves survival by 1-4 months, is NOT COST-EFFECTIVE.π pic.twitter.com/ocaTl2ZzRB
β Amar Kelkar, MD, MPH, FACP (@amarkelkar) December 5, 2023
This sentiment was echoed by hematologist Aaron Goodman, who suggested that, while pharmaceutical companies may contest the findings, this independent analysis should be viewed as trustworthy.
CART not cost effective in second line DLBCL. I'm sure pharma will run their own analysis and show the opposite. I would trust this one. https://t.co/quczxBdlfg
β Aaron Goodman - "Papa Heme" (@AaronGoodman33) December 5, 2023
The study also stirred up discussions around financial considerations for healthcare institutions. Dr. Ayushi Chauhan drew attention to the economic burden smaller cancer centers like Georgia Cancer Center have to bear, revealing their losses of about "$70-80k per commercial CAR-T patient."
Elegant analysis @amarkelkar! Congratulations! In addition, for smaller cancer centers like ours @GACancerCenter, insurance never pays us the full cost of the CAR-T therapies and we go into the red about 70-80k per commercial CAR-T patient.
β Ayushi Chauhan (@Chauhan_AF) December 5, 2023
Though the study critiques the cost-effectiveness of CAR-T therapy, it doesn't undermine its clinical benefits entirely. Dr. Jonathan Berry underlined CAR-T therapy's effectiveness, while also acknowledging the significant financial implications of this expensive therapy.
Truly important work from @amarkelkar and colleagues.
β Jonathan Berry (@jlberrymd) December 5, 2023
CAR-T is undoubtedly a helpful and effective therapy, but this demonstrates the massive economic impact of moving a highly expensive therapy earlier, and that it doesn't come close to widely-accepted value propositions. https://t.co/6Y5NAxXLYF
Krishna Komanduri, MD, also recognized these cost and value concerns, suggesting a need for comparisons with alternative therapies' cost and effectiveness.
An important analysis that should make us think. Deserves confirmation and consideration of cost and value of competing therapies. Also notable that salvage chemotherapy is relatively cheap but not terribly effective. #immunotherapy https://t.co/O8XikvAYmx
β Krishna Komanduri, MD, FASTCT (@drkomanduri) December 5, 2023
In conclusion, numerous physicians suggest that price adjustments are a crucial aspect for the broader adoption of this potentially life-saving treatment. As put concisely by Vinson Yew, "CAR-T needs $100k shaved off the sticker price to be cost effective" and echoed Dr. Samer Al Hadidi's call for a "$100,000-$150,000" reduction in the price of these treatments. However, despite the concerns raised regarding the cost-effectiveness of CAR-T, the conversation underscores its merit in the progression of treatment for certain cancers.
Proud of @amarkelkar leading this important work @AnnalsofIM , solution is easy, drop the price of those products 100,000-150,000$ and all will be good. We need more independent cost effectiveness analysis like this one π https://t.co/trztdhryuT
β Samer Al Hadidi, MD,MS,FACP (@HadidiSamer) December 5, 2023
by Brian Shields
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