The per-patient cost of the recently approved chimeric antigen receptor (CAR) T-cell therapy tisagenlecleucel could exceed $1 million, according to a report from Kaiser Health News. Though the drug launched with a $475,000 price tag, hematologists/oncologists estimate that costs of managing treatment-related adverse events and subsequent procedures will eventually add more than $500,000 to the total cost of the therapy.
Tisagenlecleucel's price tag has "shattered oncology drug pricing norms," said Leonard Saltz, MD, from Memorial Sloan Kettering Cancer Center in New York, adding that "the sticker price is just the starting point." For this class of drugs, he added, consumers should "think of the $475,000 as parts, not labor."
CAR T-cell therapy is expensive because of its unique mechanism of action. The collection and manufacturing processes also add to the total costs. Regarding tisagenlecleucel-related hospitalization and medications, "costs will vary from patient to patient and treatment center to treatment center, based on the level of care each patient requires," a spokesperson from Novartis, the drug's manufacturer, said. "[Tisagenlecleucel] is a one-time treatment that has shown remarkable, early, deep, and durable responses in these children who are very sick and often out of options."
To mitigate concerns over the drug's list price, Novartis entered a unique "outcomes-based" payment model with the U.S. Centers for Medicare and Medicaid Services. The system will not pay for tisagenlecleucel unless the pediatric or young adult patient with acute lymphoblastic leukemia who receives it responds to the treatment within 30 days of administration.
Source: Kaiser Health News, October 17, 2017; Novartis press release, June 23, 2017.