Introduction: Chimeric antigen receptor (CAR) T-cell therapy offers significant benefits for patients with lymphoid malignancies, and more recently, multiple myeloma (MM). However, the limited number of authorized treatment centers (ATC) remains a barrier for patient access. In the US, recent efforts to expand access have led to the launch of new, geographically diverse ATCs, many without FACT (Foundation for the Accreditation of Cellular Therapy) accreditation at launch. Real-world outcomes and healthcare resource utilization (HCRU) at these sites remain understudied. Therefore, we sought to assess post-infusion HCRU among patients treated with CAR T at new US ATCs, defined as centers authorized from 2023 onward without FACT accreditation during the analysis period.

Methods: This retrospective observational study used open claims data from the HealthVerity Marketplace (HV) dataset between July 2023-June 2025. The HV Marketplace open claims dataset includes de-identified US medical and pharmacy claims from commercial, Medicare Advantage, and Medicaid payers, with nationwide geographic coverage. Adults (≥18 years) were included if there was evidence of inpatient CAR T-cell infusion at a new ATC, based on information in the submitted claim, including a combination of procedure and billing codes. Key outcomes assessed included disease-specific HCRU measures within 30 days post-infusion: infusion-related hospitalization length of stay (LOS), intensive care unit (ICU) admissions, and 30-day readmission rates. Analyses primarily used descriptive statistics and graphical summaries; results with sample sizes <11 are not reported to protect privacy. This abstract presents preliminary analyses and results.

Results: A total of 43 patients received CAR T-cell therapy across 4 new ATCs located in the Midwest and South (authorized in 2023), Northeast (2024), and Southwest (2025). Among these patients, 26 had B-cell lymphoma, 14 had MM and the remaining three had other hematological cancers. Our results showed a growing number of patients treated with CAR T at new ATCs over time; the infusions increased from <11 patients treated in 2023, to 16 in 2024, and 22 in the first half of 2025.

In the non-MM group, most had diffuse large B-cell lymphoma (DLBCL; n = 21/29), and axicabtagene ciloleucel was the predominant product used (n=14/29). For MM patients, the most common CAR T-cell product used was idecabtagene vicleucel (n=12/14). The mean age was 69.4 years (standard deviation [SD]: 13.0) for the non-MM patients and 66.4 years (SD: 8.1) for MM patients. Most patients were male; 65.5% in the non-MM patients and <72% among MM patients.

Among the non-MM group, the mean LOS for the infusion-related hospitalization was 18.0 days (SD: 8.7 days; Range 7– 49 days); ICU admission rate were infrequent and observed in <11% (LOS of 1 day each). Thirty-day readmissions were observed in <18% of patients with a mean LOS of 8.5 days (SD: 6.6 days). For MM patients, the mean LOS for the infusion-related hospitalization was 11.4 days (SD: 4.3 days; Range 7– 22 days). Thirty-day readmissions occurred in <15% of patients, with no ICU admissions reported during either the initial infusion-related hospitalization or subsequent readmissions in this group.

Among MM patients, the most common comorbidities - renal disease, diabetes (with or without complications), congestive heart failure, and chronic obstructive pulmonary disease (COPD) - each occurred in <35% of patients. In the remainder of the study population, COPD was the most prevalent comorbidity (45%), followed by diabetes and renal disease (each <30%).

Conclusion: These findings show that CAR T-cell therapy is being used more frequently at newly established ATCs without FACT accreditation at the time of launch. The ability to deliver CAR T-cell therapy at more centers in geographically diverse areas, including rural and underserved regions, highlights the potential to reduce disparities and improve patient access. Notably, post-infusion HCRU are consistent with previously published data, suggesting manageable resource use. While further research is needed to evaluate clinical outcomes and costs, these early results support the feasibility of expanding CAR T delivery beyond traditional centers and improving access across a broader range of care settings.

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2025
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