Abstract
Virtually no other topic has attracted more attention in oncology in recent years than chimeric antigen receptor (CAR) T‑cell therapy (CART). On the one hand it opens up completely new treatment options for cancer patients, while on the other it generates treatment costs exceeding € 300,000 per treatment. The aim of this work is to analyze the economic, procedural and organizational challenges of CAR T‑cell therapy from the perspective of the service provider, the cost-bearer and the pharmaceutical manufacturer. The current German diagnosis-related-group (G-DRG) catalog, the G‑DRG tariff, of the German Federal Joint Committee (G-BA) guidelines and G‑DRG coding principles were used to evaluate the reimbursement and remuneration system in Germany. Practical experiences of medical sites were integrated in the analysis. The findings demonstrate great economic challenges especially from the perspective of aCART site. Increasing certification and qualification efforts lead to financial pressure. Insufficient reimbursement and inadequate cost-covering for CART treatment result in budget restrictions for hospitals. High drug costs as well as enormous personnel and infrastructural requirements demand transparent and sufficient reimbursement for hospitals. Interaction between hospital and pharmaceutical manufacturer in the CART process might enable new means of cooperation.
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