ADVI Research: Medicare Beneficiaries with Multiple Administrations of CAR-T

ADVI Health Strategic Analytics, Value and Economics (SAVEs) chief data scientist, Pete Kardel, and the team presented four poster presentations at ISPOR 2024. One of the studies analyzed the long-term outcomes associated with CAR T Therapy for Medicare and Medicare Advantage populations.

When CAR-T Therapy was approved at the end of 2017, as a very expensive therapy costing over $400K for each administration. 

Now that it has been on the market for over seven years, people are starting to ask questions about the long-term outcomes associated. One of those questions is how often people receive two CAR-T therapies and whether this is beneficial. And, which types of people receive two treatments? 

Those questions have been difficult to answer because this is a fairly rare treatment with limited data and the published literature can only be found in case study findings. 

This study assessed the Medicare Fee-For-Service (FFS) and Medicare Advantage claims from 2017. The study found over 6,100 unique beneficiaries that received CAR-T, and of those 160 beneficiaries (3 percent) had multiple administrations of CAR-T. The study found that demographically, these beneficiaries with multiple CAR-T therapies look very similar to those with only one administration. 

When both administrations of CAR-T were in the inpatient setting, the average time between administrations was 314 days, or roughly 10 months. 75 percent of these beneficiaries received at least one of the CAR T administrations in a clinical trial.

Finding 160 beneficiaries who qualified for multiple CAR T opens the door for several interesting studies. Our team will be interested in examining the patient journey between the two events, what new diagnoses they received, or stages of cancer. Additionally, with this volume, our team can assess downstream outcomes after the second CAR-T and determine the effectiveness compared to a single administration.

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ADVI experts will continue to analyze trends in the claims data related the latest on cell and gene therapy. Get in touch today to gain expert insights on the evolving healthcare landscape.

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Peter Kardel, MA
Vice President, Strategic Analytics Value and Economics