The independent research report by the IQVIA Institute for Human Data Sciences referenced in this article was funded by Gilead and Kite through the provision of arms-length funding. This article was commissioned by Gilead and Kite who reviewed the content and provided feedback.
Murray Aitken, Executive Director of the IQVIA Institute shares insights on the IQVIA Institute Report which highlights discrepancies in healthcare system readiness to deliver CAR T-cell therapies across Europe, Canada, and Australia.
The independent report from the IQVIA Institute of Data Science highlights discrepancies in healthcare system readiness to deliver innovative cancer treatments such as CAR T-cell therapies across seven countries, and the strategic actions needed to overcome access challenges and fulfil the promise of these innovative therapies. At a time of rising pressure on, and demand for, cancer services, CAR T-cell therapy represents a transformative shift in blood cancer treatment. Unless we take action, lives lost to cancer in Europe are set to increase by more than 24% by 2035.1 The recommendations in the report are essential in highlighting what steps must be taken to ensure eligible patients are able to benefit from this innovative treatment.
What was the purpose of this report? Why is it important to have an independent understanding of the current state of access to CAR T-cell therapy?
The report, which was produced independently by IQVIA Institute for Human Data Science, allows us to get an unbiased, data-driven view of the real-world challenges patients face in accessing the potentially life-saving treatment CAR T-cell therapy. Funding for the research was provided by Gilead and Kite, which had the opportunity to review the findings, but had no editorial control over the final content.
The report looks at discrepancies in healthcare system readiness to deliver innovative cancer treatments such as CAR T-cell therapies across seven countries: France, Germany, Spain, Italy, the UK, Canada and Australia.
CAR T-cell therapy is a complex innovative therapy that harnesses the body’s own immune system to target and treat cancer. The success that CAR T-cell therapy has had in helping treat patients with difficult-to-treat cancer in recent years hinges not just on the efficacy of the therapy itself, but on a whole host of factors related to access, infrastructure, and patient pathways. Despite the clinical advances in the cell therapy treatment landscape, the global haemato-oncology community and patients continue to experience disparities in access to innovative therapies such as CAR T-cell therapy. The report helps us identify the gaps between the promise of innovation and the reality on the ground and is essential for improving access and patients’ quality of life.
What were the key findings from the report? Were any of these surprising or currently unrecognised in our understanding of CAR T-cell therapy access?
The IQVIA Institute report highlights several considerations for international health systems to deliver CAR T-cell therapies. The most striking finding was the variation in utilisation rates across different countries, with some as low as 11% for eligible patients.2 The fact that some countries are only treating a small fraction of eligible patients suggests that there are substantial barriers to access that need to be addressed urgently.
There is an urgent need for stakeholders to work collaboratively to address these barriers to improve patient access, and in turn, improve patients’ quality of life.
The report identifies several factors contributing to the disparities in CAR T-cell therapy access across countries. What were some of the key barriers identified from the research?
The report highlights three main barriers to CAR T-cell therapy access. First, referral pathways are often unclear or underutilised, with many physicians unaware of how to refer eligible patients. In Spain, for example, 61% of physicians cited delays between referral and treatment as a challenge.2 In Italy and Germany, the lack of standardised pathways can also be a major challenge to timely referral.2
Second, treatment centre capacity is limited in most countries studied, making it difficult to meet patient demand. Six out of seven countries indicated that treatment centres face limited capacity challenges to deliver CAR T-cell therapy.2
Many centres simply don’t have the resources or infrastructure to treat all of the patients who are eligible for CAR T-cell therapy. Finally, the lack of comprehensive national strategies in many countries is a significant impediment, with five countries investigated do not have national strategies to access CAR T-cell therapy.2
Without a coordinated and strategic approach, it’s difficult to ensure that CAR T-cell therapy is accessible to all who need it.
What are the implications of the barriers identified in the report for patients eligible for CAR T-cell therapy?
The implications for the barriers identified in the report are serious and far-reaching. These barriers can lead to delays in treatment and may reduce the chances of a successful outcome due to disease progression. More than 50% of patients in some countries have to wait approximately two months for treatment.2 In Italy, while 80% of DLBCL patients referred receive treatment, only 38% receive treatment within a month of referral.2 Delays in referral and treatment initiation, driven by factors like capacity constraints and reimbursement hurdles, can lead to disease progression and reduced eligibility which can impact survival.
Ultimately, these barriers contribute to inequitable access to CAR T-cell therapy. Patients in certain regions or with limited resources may be less likely to receive this highly personalised therapy.
What potential solutions does the report recommend for improving access to CAR T-cell therapy?
The report outlines several potential solutions that could help to improve access to CAR T-cell therapy. One key recommendation is streamlining referral pathways to help physicians more easily identify and refer eligible patients. It also highlights the need for national strategies that include clear goals, timelines, and performance metrics to guide CAR T-cell therapy implementation. Referrals are a major challenge across countries, with 61% of referring physicians in Spain citing the time between referral and treatment as a barrier to access CAR T-cell therapy.2
Regular monitoring of access and utilisation is another key recommendation. It’s important to develop plans to regularly monitor progress and timely access to CAR T-cell therapy.
Long-term assessment and monitoring are required to address low utilisation rates across countries, as shown in Spain where a reported increase in utilisation from 14% to 18% between 2022 and 2023 was driven by national planning and policy decisions.2 It’s vital for countries to develop comprehensive national strategies for CAR T-cell therapy implementation. This should include clear goals, timelines, and performance metrics.
What role can healthcare authorities and policymakers play in ensuring equitable access to CAR T-cell therapy? Why is it important that European policymakers take action?
Healthcare authorities and policymakers have a critical role to play in ensuring equitable access to CAR T-cell therapy. Policymakers can set policies and regulations that promote access, allocate resources to support treatment centres, and develop strategies to address the barriers identified in the report.
Action from European policymakers is especially important given the diversity of healthcare systems across the region. By collaborating to share best practices and tackle common challenges, they can help ensure that all eligible patients, regardless of their country of residence, have the opportunity to benefit from these innovative one-time treatments.
European policymakers can play a key role in establishing standardised data collection and reporting systems for CAR T-cell therapy outcomes. This would allow for better monitoring of treatment effectiveness, identification of disparities, and evidence-based policy making.
References
- Europe’s Beating Cancer Plan: A new EU approach to prevention, treatment and care (2021)
- IQVIA Institute. Achieving CAR T-cell Therapy Health System Readiness. Available here: https://www.iqvia.com/Insights/The-IQVIA-Institute/Reports-and-Publications/Reports/Achieving-CAR-T-cell-Therapy-Health-System-Readiness. Accessed October 2025.
