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@ARTICLE{Pennings:310364,
      author       = {E. R. A. Pennings and F. W. Thielen and F. Broussais and J.
                      Delgado and U. Jaeger and C. Sanges and Y. Cabrerizo and L.
                      Roux-Opstaele and C. Dreuillet and E. Gonzalez-Marcano and
                      O. Millán and B. Huber and S. Clavreul and N. Bolaños and
                      S. Nier and J. Mihályová and R. Hájek and M. Horňáková
                      and R. Doeswijk and C. Thieblemont and M. Hudecek$^*$ and C.
                      A. Uyl-de Groot and M. J. Kersten},
      title        = {{T}he {E}uropean {CAR}-{T} map-{C}urrent status and future
                      directions to improve access to {CAR} {T}-cell therapy for
                      hematologic malignancies.},
      journal      = {HemaSphere},
      volume       = {10},
      number       = {3},
      issn         = {2572-9241},
      address      = {Hoboken},
      publisher    = {John Wiley $\&$ Sons Ltd.},
      reportid     = {DKFZ-2026-00560},
      pages        = {e70306},
      year         = {2026},
      note         = {#NCTZFB9#},
      abstract     = {Despite its great promise, implementation of CAR-T
                      therapy-a personalized, logistically complex, and expensive
                      treatment-remains challenging, hampering patient access
                      across and within countries. Since 2018, six products have
                      been centrally approved in Europe (i.e., the European
                      Economic Area; EU-approved) for 15 hematologic malignancy
                      indications. To better understand patient access to
                      EU-approved commercial CAR-T therapy, we evaluated the
                      current status in all 30 countries where EU-approval is
                      valid plus the UK, addressing economic, clinical, and
                      organizational aspects, and identifying challenges and
                      strategies for improvement. A two-step approach was used,
                      complementing data from marketing authorization holders (4/4
                      responded) with country-specific insights from clinical
                      experts obtained via an online survey (30/31 responded). In
                      August 2024, $26\%$ of the 31 countries had no CAR-T
                      products commercially available, $74\%$ ≥ 1 product for
                      non-Hodgkin lymphoma and leukemia, and $16\%$ ≥ 1 product
                      for multiple myeloma. One-time payment was the most used
                      reimbursement method. Time to access varied significantly,
                      with medians ranging from 0 (France/Germany) to 53 months
                      (Slovakia). The median number of qualified CAR-T centers per
                      10 million population per country was 5.0 (IQR: 3.0-6.1). In
                      most countries, patient eligibility assessment was
                      decentralized. Costs and logistical complexity were main
                      factors restricting access in countries with and without
                      commercially available products. Proposed solutions included
                      cost reductions, improving reimbursement processes, and
                      increasing healthcare resources. This study shows that
                      patient access to commercial CAR-T therapy in Europe remains
                      limited. Its insights into this multi-faceted problem can
                      guide policy-making, advocacy work, and research to make
                      this transformative treatment accessible to more patients in
                      need.},
      cin          = {WA01},
      ddc          = {610},
      cid          = {I:(DE-He78)WA01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:41799248},
      pmc          = {pmc:PMC12961523},
      doi          = {10.1002/hem3.70306},
      url          = {https://inrepo02.dkfz.de/record/310364},
}