CAR T-Cell Therapy Will Now Be Covered By Medicare

CAR T-cell therapy works by improving the way natural T cells function. T cells are fighter cells that are a normal part of our immune system. They normally roam throughout the body to seek out and attack abnormal cells.


With this therapy, some of a patient’s T cells are removed from their body, and are altered so they can fight cancer. It is called CAR T-cell therapy because a lab-made protein, a CAR protein, is added into the patient’s own T cells. The CAR protein helps T cells find and target cancer cells to be killed. The new CAR T-cells are injected back into the patient’s body to go to work. Some researchers have called this “a living drug” since the T cells can divide and give rise to more T cells in a self-limiting chain reaction.



Each CAR-T cell infusion is individual, created from the patient’s own cells. This is designed as a one-time treatment. It can continue to be active in the body for a long time.




Cart T-Cell Therapy: Very Expensive

Right now, CAR T therapy is a very complex and expensive cancer treatment. It is only available at a few dozen cancer centers. Up until know no insurance companies were offering coverage for this treatment. Indeed, one treatment can cost close to $500,00 dollars!


However, Medicare, with their recent announcement, has stepped into this breach and will now provide coverage.




Car T Cell Therapy

CAR T-Cell Therapy: Medicare Will Now Cover It

Great news! Medicare will now begin nationwide coverage of CAR T-cell therapy, the Centers for Medicare and Medicaid Services (CMS) announced earlier this week.


Medicare said it will cover CAR T-cell therapy when it is performed in facilities enrolled in an FDA safety program that includes training in handling side effects of such treatments.


Recent dramatic progress in the development of CAR T-cell therapies that harness patients’ own immune cells to treat their cancers, motivated CMS to begin funding this procedure. And by doing so, both the FDA and CMS gather important data to understand how different patients’ cancers respond to these treatments. In addition it also helps to design protocols that can minimize the negative side affects.

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