In the fight against some forms of blood and lymphatic cancer, doctors have been achieving considerable successes with a new form of immunotherapy for some time now. However, this therapy is very expensive. Manufacturers charge an impressive 320,000 euros for the production of immune cells for a single patient. Scientists from the German Cancer Research Center (DKFZ) have now found a method to produce cellular immunotherapy for about one tenth of this price.
For this therapy, the patient’s own immune cells (T-cells) are first removed from the body. These are then equipped in the laboratory with the gene for a special receptor protein to better attack the malignant leukemia cells. This “chimeric antigen receptor” (CAR) recognizes as target structure a protein molecule that is formed by each cancer cell in certain forms of leukemia, according to the researchers. These CAR T cells are then multiplied and returned to the patient. The results of the therapy so far have been “spectacular”: two years after the therapy, 40 to 60 percent of the people treated are still living without relapse.
“CAR T cell therapy is still only possible for certain cancer patients, but there is hope that this approach can be extended to other types of cancer,” explains Michael Schlander, a health economist at the German Cancer Research Centre. “There is great fear that our health care system will no longer be able to bear these costs as the number of patients increases.”
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So far, only two major pharmaceutical companies have developed such CAR-T cell products, but many research institutes are now working on them. The DKFZ is also working on its own production of therapeutic cells and has, for the first time, broken down the costs of producing CAR-T cell therapies in detail.
This complete cost calculation includes the furnishing of a clean room, laboratory material and equipment, and all wage and ancillary costs for the specially trained laboratory staff. As the calculated costs were highly dependent on the capacity utilization of the fully automated production system, the researchers based their calculations on different scenarios. These included a maximum annual capacity utilization of the equipment with 18 CAR-T cell products.
Cost savings and patient benefits
In the end, the researchers concluded that the production of a CAR-T cell product in the DKFZ would cost less than 60,000 euros for one patient. This is in contrast to the current 320,000 euros. “This would only be about one-fifth of the price charged by companies. And our costs can even be reduced considerably further,” emphasizes Michael Schlander. The biggest further savings can be made if several of the automated production devices are operated at the same time. An alternative method of transferring the genes for the chimeric receptor could further reduce production costs to around 33,000 euros, or one-tenth of the current commercial price, according to the scientists.
In addition to the immediate cost savings, the decentralized production of CAR-T cells would also be of enormous benefit to patients. “By eliminating the time needed to send the patient’s blood and the finished cell therapy, we can make the treatment available within 12 to 14 days,” says immunologist Stefan Eichmüller. “A significant reduction in the waiting time associated with commercially available products from three to four weeks. Patients would then need less chemotherapy and would have to stay in the hospital for less time – which would lead to further cost savings.”
Any costs for licence fees are not included in DKFZ’s cost calculation. Schlander and Eichmüller hope that their current study can convince manufacturing companies to “reconsider their current prices for CAR-T cell therapies”.
main photo: DKFZ employees count down the CAR-T cells under cleanroom conditions Source: Stefan Eichmüller/DKFZ.
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