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
Abstract
BACKGROUND: Acute lymphoblastic leukemia (ALL) is the most common
malignancy of childhood. With the introduction of novel cellular
therapies, cost of care is a critical component and financial toxicity
experienced by patients and society requires evaluation. This study aims
to assess the total cost of CAR-T therapy for pediatric ALL patients
with commercial insurance coverage in the United States. STUDY DESIGN:
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. RESULTS: Among the 37 identified 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 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 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 ALL
therapy on health systems.