INTRODUCTION: Chimeric Antigen Receptor T cell (CAR-T) therapy is a personalised technology whereby a patient’s own T-cells can be re-programmed to target and kill cancer cells. CAR-T is currently reimbursed for Diffuse large B cell lymphoma (DLBCL), primary mediastinal large B cell lymphoma (PMBCL) and acute lymphoblastic leukaemia (ALL) in Ireland. The number of patients receiving CAR T-cell therapy and the respective treatment cost is not well reported in Ireland.

OBJECTIVES: To estimate the total cost of care among patients with DLBCL treated with CAR T-cell therapy in Ireland.

METHODS: A micro costing approach was utilised to calculate the healthcare resource use (HCRU) required for DLBCL patients receiving CAR T-cell therapy in 2022 and 2023. Data was collected from the Irish Healthcare Pricing Office and clinical elicitation for the number of patients undergoing leukapheresis with the primary diagnosis of DLBCL. The estimated patient HCRU pathway was validated with a health care professional working in an Irish transplant centre currently administering CAR T-cell therapy (n=1). The estimated costs were calculated for a patients first year of treatment.

RESULTS: The estimated HCRU cost for patients receiving CAR T-cell therapy based on 22 patients in 2022 and 35 patients in 2023 was €7.4M and €11.8M, respectively. This indicated an estimated increase of €4.4M from 2022 to 2023.

CONCLUSIONS: The findings demonstrate an increasing demand for CAR T cell therapy for treating DLBCL in Ireland. Furthermore, future indications for CAR T-cell therapy will include disease areas such as multiple myeloma, mantle cell lymphoma and solid tumours. This increased financial demand will place additional pressure on the Irish healthcare budget, which is already constrained and will require expansion of the current service provision within Ireland.