Access to CAR T-cell therapy across diverse global markets

Efforts to expand access to chimeric antigen receptor (CAR) T-cell therapy have moved rapidly in the scientific domain but far more slowly in health systems.In this issue of Blood, Ge et al 1 offer a comprehensive attempt to map the mismatch between innovation and implementation across the G20 countries and selected additional jurisdictions.The cross-country analysis outlines how national health technology assessment (HTA) processes and manufacturer strategies shape the real-world availability of CAR T-cell therapies.The authors reviewed all US Food and Drug Administration (FDA)-approved commercial CAR T-cell indications and documented whether each indication had received public reimbursement across other countries.Fewer than half of all indications (48%; 122/252) receive public funding across the countries with available HTA data.Reimbursement clusters in a handful of high-income settings.Even within those settings, coverage is uneven across indications.After the United States, countries such as France and Germany reimburse most indications.Others, including Australia and the United Kingdom, fund fewer than half.