Cell and gene therapies are reshaping cancer treatment. The product of decades of research, these new therapies treat cancer at its source, empowering a patient’s own immune cells to attack the disease. For individuals with leukemia, lymphoma, or multiple myeloma, outcomes may include long-term remission or freedom from cancer, even after chemotherapy and other treatments had been tried unsuccessfully.
Side effects of gene therapy are relatively small compared to those more traditional approaches and the benefits can be profound.
The Cost of Innovation
While a revolutionary treatment like this can reshape the cancer community, its unique promise comes at a steep cost. A one-time infusion of chimeric antigen receptor (CAR) T-cell therapies can cost from $300,000 to more than $4 million, making even a standard copay or coinsurance prohibitively expensive. Despite their cost, these medications have been shown to provide value over time, making it critical to find innovative ways to pay for these treatments. For instance, the Centers for Medicare and Medicaid Services is considering innovative payment models that aim to help state Medicaid plans afford and provide treatment.
Location Limits Access
Even if a patient has excellent insurance, logistical barriers may prevent them from receiving cell and gene therapies. Most cell and gene therapies are administered at large academic medical centers, and patients living more than two hours from these centers are significantly less likely to receive treatment. Those who had to travel between two and four hours were almost 40% less likely to receive CAR T-cell therapy. The treatment’s price tag is compounded by the indirect costs of travel, lodging and lost work, further limiting patients.
Equity Must Shape the Future of Care
Investment in this field is accelerating, and many new therapies are expected in coming years. But without deliberate efforts to expand access, these breakthroughs may remain reserved for only those who can afford them. Addressing both cost and geography is essential, especially as the expected benefits of increased adoption of gene therapies could reduce overall spending on cancer care. Without progress on these fronts, the transformative potential of cell and gene therapies risks being out of reach for too many patients.
