What does this research mean for the field?

Significant barriers to CAR-T cell therapy access, including insurance coverage, distance to centers, and out-of-pocket costs, disproportionately affect marginalized populations and require new strategies and policy changes to ensure equitable access. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To identify and characterize the clinical, financial, and logistical barriers that prevent eligible patients with hematologic malignancies from accessing CAR-T cell therapy.

August 22, 2026International Journal of Cancer Care and Delivery0 citationsOpen Access

Bridging the Access Gap to CAR-T Cell Therapy

KSKrithika Shanmugasundaram KBKaren Ballen

Key Points

To identify and characterize the clinical, financial, and logistical barriers that prevent eligible patients with hematologic malignancies from accessing CAR-T cell therapy.
Reviewed delivery challenges and clinical pathways for CAR-T cell therapy across indications including non-Hodgkin lymphoma, acute lymphoblastic leukemia, and multiple myeloma.
Assessed the impact of socioeconomic factors, insurance coverage disparities, geographic distance to treatment centers, and supportive care costs on therapy access.
Fewer than 50% of eligible candidates with relapsed or refractory hematologic malignancies currently receive CAR-T cell therapy.
Access barriers—including insurance restrictions, travel distances to authorized centers, and non-medical costs like lodging and childcare—disproportionately impact racial minorities, rural populations, and lower-income groups.
Improving therapy utilization requires a combination of clinical advancements, local support infrastructure, and state-level policy reforms.

Abstract

Although chimeric antigen receptor T-cell (CAR-T) therapy is a highly effective and tolerable cellular therapy for relapsed and refractory non-Hodgkin lymphoma, acute lymphoblastic leukemia, and multiple myeloma, less than half of patients who are eligible for CAR-T therapy receive it.Barriers to access include differences in insurance policies and coverage, distance to a CAR-T center, availability of caregiving and social support, and costs of supportive medical care surrounding CAR-T treatment.These barriers disproportionately affect minorities, rural populations, and lower income families.Some medical advancements in CAR-T therapy are focused on decreasing some of these barriers and community efforts have attempted to bridge these gaps.Ultimately, new strategies and state-level policy changes are needed to overcome these barriers to increase equitable access to CAR-T cell therapy for all patients who need this treatment.Delivery 2026;6789102.Major barriers to CAR-T cell therapy include insurance coverage, distance to a CAR-T center, caregiving support, and unseen costs of medical care (additional childcare, travel, lodging, supportive medications).Patients need readily available support and strategies to overcome these barriers. binaytara.org/journal | Shanmugasundaram et al. International Journal of Cancer Care and3. These barriers disproportionately affect certain populations of patients, including ethnic minorities, lower income families, rural populations, and patients that fall within a lower socioeconomic status, and thus active strategies are needed to help these populations gain improved access to CAR-T cell therapy.

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