{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T11:53:14Z","timestamp":1791546794090,"version":"4.3.4"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"},{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"funder":[{"DOI":"10.13039\/501100000664","name":"Health Technology Assessment Programme","doi-asserted-by":"publisher","award":["NIHR177737"],"award-info":[{"award-number":["NIHR177737"]}],"id":[{"id":"10.13039\/501100000664","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["PharmacoEconomics"],"DOI":"10.1007\/s40273-026-01673-6","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T11:10:53Z","timestamp":1791544253000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Methodological Challenges and Preferred Approaches for the Economic Evaluation of CAR T Therapies: Evidence Review and Expert Consensus from NICE Appraisals"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4791-7866","authenticated-orcid":false,"given":"Mehdi","family":"Yousefi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8879-7565","authenticated-orcid":false,"given":"Amin","family":"Mehrabian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2702-397X","authenticated-orcid":false,"given":"Maeve A.","family":"O\u2019Reilly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4901-5858","authenticated-orcid":false,"given":"Claire","family":"Roddie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5143-3218","authenticated-orcid":false,"given":"Peter","family":"Auguste","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4027-8456","authenticated-orcid":false,"given":"Dawn","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6542-8492","authenticated-orcid":false,"given":"Jo","family":"Parsons","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0506-9384","authenticated-orcid":false,"given":"Daniel","family":"Gallacher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,9]]},"reference":[{"issue":"6382","key":"1673_CR1","doi-asserted-by":"publisher","first-page":"1361","DOI":"10.1126\/science.aar6711","volume":"359","author":"CH June","year":"2018","unstructured":"June CH, O\u2019Connor RS, Kawalekar OU, Ghassemi S, Milone MC. CAR T cell immunotherapy for human cancer. Science. 2018;359(6382):1361\u20135.","journal-title":"Science"},{"issue":"26","key":"1673_CR2","doi-asserted-by":"publisher","first-page":"2531","DOI":"10.1056\/NEJMoa1707447","volume":"377","author":"SS Neelapu","year":"2017","unstructured":"Neelapu SS, Locke FL, Bartlett NL, Lekakis LJ, Miklos DB, Jacobson CA, et al. Axicabtagene ciloleucel CAR T-cell therapy in refractory large B-cell lymphoma. N Engl J Med. 2017;377(26):2531\u201344.","journal-title":"N Engl J Med"},{"issue":"1","key":"1673_CR3","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1056\/NEJMoa1804980","volume":"380","author":"SJ Schuster","year":"2019","unstructured":"Schuster SJ, Bishop MR, Tam CS, Waller EK, Borchmann P, McGuirk JP, et al. Tisagenlecleucel in adult relapsed or refractory diffuse large B-cell lymphoma. N Engl J Med. 2019;380(1):45\u201356.","journal-title":"N Engl J Med"},{"issue":"4","key":"1673_CR4","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1200\/JCO.19.01558","volume":"38","author":"MD Whittington","year":"2020","unstructured":"Whittington MD, McQueen RB, Campbell JD. Valuing chimeric antigen receptor T-cell therapy: current evidence, uncertainties, and payment implications. J Clin Oncol. 2020;38(4):359\u201366.","journal-title":"J Clin Oncol"},{"issue":"1","key":"1673_CR5","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1007\/s41669-025-00614-x","volume":"10","author":"N Patel","year":"2026","unstructured":"Patel N, Farid S, Gomes M. Cost-effectiveness of chimeric antigen receptor (CAR) T-cell therapy for blood cancers: an updated systematic review. PharmacoEconomics - Open. 2026;10(1):35\u201351.","journal-title":"PharmacoEconomics - Open"},{"issue":"8","key":"1673_CR6","doi-asserted-by":"publisher","first-page":"1149","DOI":"10.1016\/j.jval.2024.04.004","volume":"27","author":"K Thavorn","year":"2024","unstructured":"Thavorn K, Thompson ER, Kumar S, Heiskanen A, Agarwal A, Atkins H, et al. Economic evaluations of chimeric antigen receptor T-cell therapies for hematologic and solid malignancies: a systematic review. Value Health. 2024;27(8):1149\u201373.","journal-title":"Value Health"},{"issue":"12","key":"1673_CR7","doi-asserted-by":"publisher","first-page":"1162","DOI":"10.1016\/j.bulcan.2021.09.001","volume":"108","author":"V Raimond","year":"2021","unstructured":"Raimond V, Kaltenbach E, Adam C, Lazzarotto S, Le Gal\u00e8s C, Perrier L, et al. Challenges raised by the economic evaluation of CAR-T-cell therapies. The review by the French National Authority for Health. Bull Cancer. 2021;108(12):1162\u20139.","journal-title":"Bull Cancer"},{"issue":"7","key":"1673_CR8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3310\/hta21070","volume":"21","author":"R Hettle","year":"2017","unstructured":"Hettle R, Corbett M, Hinde S, Hodgson R, Jones-Diette J, Woolacott N, et al. The assessment and appraisal of regenerative medicines and cell therapy products: an exploration of methods for review, economic evaluation and appraisal. Health Technol Assess. 2017;21(7):1\u2013204.","journal-title":"Health Technol Assess"},{"key":"1673_CR9","unstructured":"National Institute for Health and Care Excellence. NICE technology appraisal and highly specialised technologies guidance: the manual. London: National Institute for Health and Care Excellence; 2022. Report No.: PMG36."},{"issue":"5","key":"1673_CR10","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1007\/s40273-025-01472-5","volume":"43","author":"J Donoghue","year":"2025","unstructured":"Donoghue J, Youngs M, Reeve A, Vydyula K, Kunst N, Trikha R, et al. Examining consistency across NICE single technology appraisals: a review of appraisals for paroxysmal nocturnal haemoglobinuria. Pharmacoeconomics. 2025;43(5):499\u2013508.","journal-title":"Pharmacoeconomics"},{"key":"1673_CR11","unstructured":"National Institute for Health and Care Excellence. Brexucabtagene autoleucel for treating relapsed or refractory mantle cell lymphoma. London: National Institute for Health and Care Excellence; 2021. Report No.: TA677."},{"key":"1673_CR12","unstructured":"National Institute for Health and Care Excellence. Axicabtagene ciloleucel for treating diffuse large B-cell lymphoma and primary mediastinal large B-cell lymphoma after 2 or more systemic therapies. London: National Institute for Health and Care Excellence; 2023. Report No.: TA872."},{"key":"1673_CR13","unstructured":"National Institute for Health and Care Excellence. Brexucabtagene autoleucel for treating relapsed or refractory B-cell acute lymphoblastic leukaemia in people 26 years and over. London: National Institute for Health and Care Excellence; 2023. Report No.: TA893."},{"key":"1673_CR14","unstructured":"National Institute for Health and Care Excellence. Axicabtagene ciloleucel for treating relapsed or refractory follicular lymphoma. London: National Institute for Health and Care Excellence; 2023. Report No.: TA894."},{"key":"1673_CR15","unstructured":"Latimer N. Survival analysis for economic evaluations alongside clinical trials: extrapolation with patient-level data. Sheffield: Decision Support Unit, School of Health and Related Research, University of Sheffield; 2013 June 2011 (updated March 2013)."},{"key":"1673_CR16","unstructured":"National Institute for Health and Care Excellence. NICE real-world evidence framework. London: National Institute for Health and Care Excellence; 2022. Report No.: ECD9."},{"issue":"9","key":"1673_CR17","doi-asserted-by":"publisher","first-page":"1277","DOI":"10.1177\/1049732305276687","volume":"15","author":"HF Hsieh","year":"2005","unstructured":"Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15(9):1277\u201388.","journal-title":"Qual Health Res"},{"issue":"1","key":"1673_CR18","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1111\/j.1365-2648.2007.04569.x","volume":"62","author":"S Elo","year":"2008","unstructured":"Elo S, Kyng\u00e4s H. The qualitative content analysis process. J Adv Nurs. 2008;62(1):107\u201315.","journal-title":"J Adv Nurs"},{"issue":"3","key":"1673_CR19","doi-asserted-by":"publisher","first-page":"458","DOI":"10.1287\/mnsc.9.3.458","volume":"9","author":"N Dalkey","year":"1963","unstructured":"Dalkey N, Helmer O. An experimental application of the Delphi method to the use of experts. Manag Sci. 1963;9(3):458\u201367.","journal-title":"Manag Sci"},{"issue":"9","key":"1673_CR20","doi-asserted-by":"publisher","first-page":"979","DOI":"10.2105\/AJPH.74.9.979","volume":"74","author":"A Fink","year":"1984","unstructured":"Fink A, Kosecoff J, Chassin M, Brook RH. Consensus methods: characteristics and guidelines for use. Am J Public Health. 1984;74(9):979\u201383.","journal-title":"Am J Public Health"},{"key":"1673_CR21","doi-asserted-by":"crossref","unstructured":"Murphy MK, Black NA, Lamping DL, McKee CM, Sanderson CF, Askham J, et al. Consensus development methods, and their use in clinical guideline development. Health Technol Assess. 1998;2(3):i\u2013iv, 1\u201388.","DOI":"10.3310\/hta2030"},{"key":"1673_CR22","unstructured":"National Institute for Health and Care Excellence. Lisocabtagene maraleucel for treating relapsed or refractory large B-cell lymphoma after first-line chemoimmunotherapy when a stem cell transplant is suitable. London: National Institute for Health and Care Excellence; 2025. Report No.: TA1048."},{"key":"1673_CR23","unstructured":"National Institute for Health and Care Excellence. Axicabtagene ciloleucel for treating relapsed or refractory diffuse large B-cell lymphoma after first-line chemoimmunotherapy. London: National Institute for Health and Care Excellence; 2023. Report No.: TA895."},{"key":"1673_CR24","unstructured":"National Institute for Health and Care Excellence. Tisagenlecleucel for treating relapsed or refractory B-cell acute lymphoblastic leukaemia in people 25\u202fyears and under London: National Institute for Health and Care Excellence; 2024. Report No.: TA975."},{"key":"1673_CR25","unstructured":"National Institute for Health and Care Excellence. Obecabtagene autoleucel for treating relapsed or refractory B-cell precursor acute lymphoblastic leukaemia. London: National Institute for Health and Care Excellence; 2025. Report No.: TA1116."},{"key":"1673_CR26","unstructured":"National Institute for Health and Care Excellence. Brexucabtagene autoleucel for treating relapsed or refractory mantle cell lymphoma after 2 or more systemic treatments (review of TA677) [ID6325]. London: National Institute for Health and Care Excellence; 2026. Report No.: GID-TA11545."},{"issue":"2","key":"1673_CR27","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1111\/bjh.19157","volume":"204","author":"S Boyle","year":"2024","unstructured":"Boyle S, Roddie C, O\u2019Reilly M, Menne T, Norman J, Gibb A, et al. Improved outcomes of large B-cell lymphoma patients treated with CD19 CAR T in the UK over time. Br J Haematol. 2024;204(2):507\u201313.","journal-title":"Br J Haematol"},{"issue":"12","key":"1673_CR28","doi-asserted-by":"publisher","first-page":"2872","DOI":"10.1182\/bloodadvances.2022009019","volume":"7","author":"C Roddie","year":"2023","unstructured":"Roddie C, Neill L, Osborne W, Iyengar S, Tholouli E, Irvine D, et al. Effective bridging therapy can improve CD19 CAR-T outcomes while maintaining safety in patients with large B-cell lymphoma. Blood Adv. 2023;7(12):2872\u201383.","journal-title":"Blood Adv"},{"key":"1673_CR29","unstructured":"Rutherford MJ, Lambert PC, Sweeting MJ, Pennington B, Crowther MJ, Abrams KR, et al. Flexible methods for survival analysis. Sheffield: Decision Support Unit, School of Health and Related Research (ScHARR), University of Sheffield; 2020. Report No.: TSD 21."},{"key":"1673_CR30","unstructured":"Oakley JE, Ren S, Forsyth JE, Gosling JP, Wilson K, Latimer N, et al. Expert elicitation for long-term survival outcomes. Sheffield: Decision Support Unit, School of Health and Related Research (ScHARR), University of Sheffield; 2025. Report No.: TSD 26."},{"issue":"37","key":"1673_CR31","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3310\/hta25370","volume":"25","author":"L Bojke","year":"2021","unstructured":"Bojke L, Soares M, Claxton K, Colson A, Fox A, Jackson C, et al. Developing a reference protocol for structured expert elicitation in health-care decision-making: a mixed-methods study. Health Technol Assess. 2021;25(37):1\u2013124.","journal-title":"Health Technol Assess"},{"issue":"11","key":"1673_CR32","doi-asserted-by":"publisher","first-page":"1469","DOI":"10.1016\/j.jval.2024.07.027","volume":"27","author":"M Soares","year":"2024","unstructured":"Soares M, Colson A, Bojke L, Ghabri S, Garay OU, Felli JK, et al. Recommendations on the use of structured expert elicitation protocols for healthcare decision making: a good practices report of an ISPOR task force. Value Health. 2024;27(11):1469\u201378.","journal-title":"Value Health"},{"issue":"6","key":"1673_CR33","doi-asserted-by":"publisher","first-page":"796","DOI":"10.1016\/j.jval.2012.06.012","volume":"15","author":"JJ Caro","year":"2012","unstructured":"Caro JJ, Briggs AH, Siebert U, Kuntz KM. Modeling good research practices\u2014overview: a report of the ISPOR-SMDM modeling good research practices task force-1. Value Health. 2012;15(6):796\u2013803.","journal-title":"Value Health"},{"key":"1673_CR34","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.s551","volume":"392","author":"G Iacobucci","year":"2026","unstructured":"Iacobucci G. Alzheimer\u2019s drugs: lecanemab and donanemab to be reconsidered for NHS after appeal. BMJ. 2026;392:s551.","journal-title":"BMJ"},{"issue":"6","key":"1673_CR35","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1177\/0272989X12472398","volume":"33","author":"NR Latimer","year":"2013","unstructured":"Latimer NR. Survival analysis for economic evaluations alongside clinical trials--extrapolation with patient-level data: inconsistencies, limitations, and a practical guide. Med Decis Making. 2013;33(6):743\u201354.","journal-title":"Med Decis Making"},{"key":"1673_CR36","unstructured":"Hsu C-C, Sandford BA. The Delphi technique: making sense of consensus. Practical assessment, research, and evaluation. 2007 Jan;12(1)."},{"key":"1673_CR37","unstructured":"National Institute for Health and Care Excellence. Use of disease-specific reference models in economic evaluations: NICE position statement. London: National Institute for Health and Care Excellence; 2025. Report No.: ECD18."}],"container-title":["PharmacoEconomics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40273-026-01673-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s40273-026-01673-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40273-026-01673-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T11:10:59Z","timestamp":1791544259000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s40273-026-01673-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,9]]},"references-count":37,"alternative-id":["1673"],"URL":"https:\/\/doi.org\/10.1007\/s40273-026-01673-6","relation":{},"ISSN":["1170-7690","1179-2027"],"issn-type":[{"value":"1170-7690","type":"print"},{"value":"1179-2027","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,9]]},"assertion":[{"value":"27 April 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 September 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 October 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare that they have no conflicts of interest relevant to this study.","order":1,"name":"Ethics","label":"Conflict of Interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethical approval for the Delphi study was obtained from the University of Birmingham Research Ethics Committee. All participants provided informed consent prior to participation.","order":2,"name":"Ethics","label":"Ethical Approval","group":{"name":"EthicsHeading","label":"Declarations"}}]}}