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While substantial health gains may justify high costs, it is currently unclear the extent to which the overall cost effectiveness of these therapies is driven by i) context-specific factors, such willingness-to-pay thresholds and study perspective, or ii) important subgroups such as line of treatment and therapy product.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This paper aims to critically review published evidence on the cost effectiveness of CAR T-cell therapies and assess the key factors that drive their cost effectiveness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a systematic review using PubMed, Scopus and Ovid (Embase) databases to identify full economic evaluations of CAR T-cell therapies published up to January 2024. One reviewer screened and extracted data from the studies and the second reviewer assessed a sample of the full-text studies against the inclusion\/exclusion criteria. Studies were critically appraised using the CHEERS checklist. Cost data are presented in 2022 US dollars.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The review identified 45 full cost-effectiveness studies of CAR T-cell therapies. These studies considered a total of 92 treatment comparisons, which included tisagenlecleucel (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a037), axicabtagene ciloleucel (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a028), brexucabtagene autoleucel (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a07), lisocabtagene maraleucel (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a08), idecabtagene vicleucel (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a06), ciltacabtagene autoleucel (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a04) and relmacabtagene autoleucel (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a02). Incremental cost ranged from \u2212\u00a0US$74,980 to US$714,178 and incremental quality-adjusted life year (QALY) gains ranged from \u2212\u00a00.02 to 10.77. The resulting cost-per-QALY-gained ratios ranged from \u2212\u00a0US$37,490,000 to US$7,972,845, and the range of willingness-to-pay (WTP) thresholds between US$36,184 to US$317,825. The price of CAR T-cell therapy represented 75% (mean US$391,060) of the total cost of CAR T-cell therapy but was not the sole factor influencing cost effectiveness. Hospitalisation made up 6% of the total cost (mean US$34,152), while adverse events accounted for 9% (mean US$47,350). Regression analysis indicated cost effectiveness did not change according to important clinical or contextual factors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The findings demonstrate that the cost effectiveness of CAR T-cell therapies is determined by a combination of factors: the relative difference between the cost of the CAR T-cell therapy and comparator, the magnitude of the QALY gains and the WTP thresholds. Their cost- effectiveness does not differ according to therapy product, line of treatment, or country.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s41669-025-00614-x","type":"journal-article","created":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T12:35:29Z","timestamp":1765802129000},"page":"35-51","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Cost-Effectiveness of Chimeric Antigen Receptor (CAR) T-Cell Therapy for Blood Cancers: An Updated Systematic Review"],"prefix":"10.1007","volume":"10","author":[{"given":"Nishma","family":"Patel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Farid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Gomes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,15]]},"reference":[{"key":"614_CR1","unstructured":"Facts and information about blood cancer [Internet]. 28 September 2023 [cited 28 September 2023]. https:\/\/bloodcancer.org.uk\/news\/blood-cancer-facts\/. 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