OBJECTIVES: Chimeric antigen receptor (CAR) T-cell therapy represents a pivotal advancement in personalized cancer treatment, particularly for relapsed or refractory B cell malignancies, where it has become a standard of care. Despite its transformative impact on cancer immunotherapy, CAR T-cell therapy confronts significant challenges, including complex regulatory requirements and accessibility barriers in Asia-Pacific (APAC) region.

METHODS: We conducted a comprehensive literature search across PubMed and Google Scholar to explore the challenges and opportunities surrounding CAR-T cell therapy accessibility. Our review focused on studies addressing issues such as affordability, availability, equity, healthcare disparities, and barriers to access. Keywords included "Chimeric Antigen Receptor T Cells" OR "CAR-T Cells" AND ("Access" OR "Availability" OR "Affordability" OR "Equity" OR "Healthcare Disparities" OR "Barriers").

RESULTS: The search yielded 316 studies from both databases and grey literature sources, with 64 selected for secondary screening. Ultimately, 22 studies were included in the final analysis. In the APAC region, public funding for CAR-T therapy primarily targets public pay markets and utilizes public-private partnerships (PPPs) to enhance healthcare system sustainability, exemplified by initiatives in Singapore. India has introduced NexCAR19, a locally developed CAR-T cell therapy for B-cell lymphoma/leukemia, offered at a lower cost compared to other therapies. Meanwhile, Malaysia and Thailand are advancing CAR-T therapies through clinical trials, adopting them on a case-by-case basis. The diverse pharmaceutical landscapes and varying readiness levels across these countries highlight the impracticality of a one-size-fits-all approach.

CONCLUSIONS: Given the high costs associated with CAR-T cell therapy, collaborative funding mechanisms among payers are essential for enhancing affordability and access. Governments can play a pivotal role by subsidizing hospital expenses, covering product costs, offering grants, and streamlining approval processes. The diversity in healthcare infrastructures across APAC underscores the need for tailored, context-specific strategies to facilitate equitable access to CAR-T therapies.