Dr Lee Schwartzberg Outlines Potential Steps to Expand Access of Novel Therapies in Immuno-Oncology

As we move from the mono-therapy era into the combination era, we have to think of new arrangements, perhaps value-based arrangements that will work with the payers and the manufacturers so that patients will have access to these drugs and also have the best ability to get value from them, said Lee Schwartzberg, MD, FACP, chief medical officer and board member at OneOncology.

Transcript

What factors must be prioritized by ACCC member organizations when it comes to expanding access to novel therapies in immuno-oncology?

There are still a lot of operational issues with these exciting new immuno-oncology (IO) agents. The biggest challenge probably is in the cellular therapy space. CAR-T cells are the first opportunity there. They're toxic—they work tremendously, but in the first few days they have to be done in-patient currently. The process of developing CAR-T cells is a long, complicated, and expensive one.

I'm confident that the next generation of technology both for CAR-T cells and managing the side effects will make this easier, but for ACCC, one needs to have a very coordinated group to understand the reimbursement challenges around cellular therapy, the operational challenges around cellular therapy, and the medical challenges around cellular therapy in terms of taking care of those side effects. We have a challenge at the community oncology level of how do we get access for our patients for these lifesaving kinds of procedures. Only a small number of patients, frankly, have been treated with the first-generation CAR-T cells. So, we need to develop new technologies and new operational models to do this.

Reimbursement remains a challenge as well. Reimbursements’ a challenge also for combinations of IO agents, which are really quite expensive. So, as we move from the mono-therapy era, into the combination era, we have to think of new arrangements, perhaps value-based arrangements that will work with the payers and the manufacturers so that patients will have access to these drugs and also have the best ability to get value from them.