Nina Chavez on How CAR T, Other Expensive Therapies Create Reimbursement Challenges

Nina Chavez, MBA, FACMPE, chief operating officer, New Mexico Oncology Hematology Consultants, Ltd., explains how expensive therapies like chimeric antigen receptor (CAR) T-cell therapy are creating reimbursement challenges.

Transcript

With therapies like CAR T-cell therapy entering the market, will reimbursement present significant challenges to providers?

CAR T—I was talking to my doctor about this because I’m not clinical and I want to make sure I got her opinion, and she said, with CAR T, the insurers are not paying for it right now, we don’t know what’s going to happen, it really should be happening in a hospital, but if you’re not partnering with your hospital and you’re trying to do it in an independent practice, it’s not going to be easy.

I think from a cost perspective, we don’t know what the market’s going to do, we don’t know what the payers are going to do. We do know that we can’t get that medication, we can’t get CAR T therapies very easily in community oncology. We can’t even get it from the [group purchasing organization] we currently have. You have to go through a certain specialty, and it is very costly. So, I think that’s remaining to be seen. It’s something that we’ll have to kind of see how it goes.