The cost of myeloma CAR T-cell therapy can be a concern for myeloma patients and care partners. Myeloma nurse practitioner Daniel Verina discusses the costs associated with care and how nonprofit organizations, case managers, and social workers can help patients navigate financial challenges and identify available resources.
Daniel Verina is a nurse practitioner at the Center of Excellence for Multiple Myeloma at Mount Sinai Tisch Cancer Center in New York City.
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Transcript
Katherine Banwell:
Daniel, CAR T can be expensive, which is a concern for many patients. Is the cost starting to come down at all? And are there resources that can help?
Daniel Verina:
Absolutely. It is, I mean, we’ve read about it, it’s been in the news. There is a good price sticker tag to the CAR T value, but I look at it as because it’s one and done, it’s a life longevity of a treatment versus every week getting a treatment alone. So, it is a little bit pricey and very high. A single CAR T is still the hundreds to thousands of dollars for treatment, but we are starting to see a little bit of decrease in the cost, well, because now it’s kind of shifting to moving it outpatient. So, now we’re not looking at the academic centers.
It’s shorter stays in the hospital, patients are either getting it done outpatient – there are considerations, but not FDA-approved right now, of decentralizing manufacturing of the CAR T. So, now they’ll have multiple facilities being able to produce these specialized T-cells, but it’s not FDA-approved yet, so really not available. I think hospitals are also getting very involved in upfront financial counseling with our patients, and clearer insurance approvals of what the costs will be, and making the appropriate agreement between the insurance company and the payer themselves.
One of the most wonderful things that I’ve seen too – two actually, two wonderful things I’ve actually seen occur is a lot of the nonprofit and foundations that are available have kind of helped support our patients with travel, lodging, and sometimes their copays.
Because I’m in New York City, and even being in Brooklyn or out in Long Island, it’s a cost to commute back and forth. And hotels, the prices of a hotel are not cheap, if you’re asking a patient to stay in a hotel for two to three weeks. So, it’s great. And some of the pharmaceutical companies are also providing financial support for our patients in these hotels, so that they know that they could get back and forth. Other things they’re involving is really importantly, grabbing another important portion – I can’t talk today, a good person that’s important to our teams is your case manager.
Case managers, social workers really help with navigating insurance because I think insurances are worse than a spider’s web. I don’t even know. It’s a labyrinth. I don’t know where I am half of the time. So, I think it’s very helpful to sometimes even advise patients, they may have to switch their insurances to be able to get the costs or less cost for it.
Because remember, you’re paying for the CAR T. You still have to pay for the aftercare, which could be intravenous immunoglobulins, IVIG, prophylactic antibiotics, follow-ups, sending them to subspecialties like a gastroenterologist, and endocrinologist, a pulmonologist. That if a symptom occurred a couple years later, now they have to go and see a specialist for that. It could be out of pocket, so again, looking at the whole picture down the line.