National Coverage Analysis of CAR-T Therapies — Policy, Evidence, and Payment

Abstract

In December 2017, the Boston radio station WBUR chronicled the case of the first patient at Massachusetts General Hospital to receive axicabtagene ciloleucel (Yescarta, Gilead) outside a clinical trial. The chimeric antigen receptor T cells (CAR-Ts) were made from 71-year-old Barbara Kearney’s own T cells, which after genetic modification ex vivo were turned on to target the CD19 receptor. CD19 is a commonly expressed surface antigen on B cells, including those of Ms. Kearney’s non-Hodgkin’s lymphoma, and also inhabits the surface of some other normal cells.¹