The latest on CAR T-cell reimbursement

April 14, 2020
Here's something cool. Music-minded scientists have assigned a unique musical note to each amino acid in the coronavirus, turning it into an eerily beautiful song—which could help them discover antibodies or drugs to treat it. Today, we’re taking a quick break from…
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Here's something cool. Music-minded scientists have assigned a unique musical note to each amino acid in the coronavirus, turning it into an eerily beautiful songwhich could help them discover antibodies or drugs to treat it.

Today, we’re taking a quick break from the coronavirus to look at what people are saying about the CAR T-cell reimbursement issue, as well as Mazda’s biofuels initiative and the latest on when Congress will return from recess, in about 615 words (3 minutes).

The latest on CAR T-cell reimbursement

 
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It’s all hands on deck in the coronavirus battle, but the industry must continue work on other breakthrough treatments—and ensure patients have access to them. Here’s a look on some of the latest activity on the CAR T-cell reimbursement issue.

Remind me, what’s CAR T? Chimeric antigen receptor (CAR) T-cell immunotherapy is a powerful cancer treatment that uses “the patient’s own immune cells to help them take on cancer,” as RealClearHealth put it, with gentler side effects than chemotherapy and radiation. 

Why are we talking about it now? Currently, Medicare covers the treatment with a new technology add-on payment (NTAP)—but this expires on September 30, 2020. Without further action by CMS, hospitals could be left with wholly inadequate payment rates for CAR T and may be reluctant to provide the therapy for America’s seniors.  

And health care execs, patients, and think tanks agree: The current Medicare inpatient payment model is confounded by the entry of breakthrough treatments and reduces patient access to them for years. 

American Action Forum (AAF), a conservative think tank, published new research saying CAR T needs its own diagnostic related group (DRG) to ensure the treatment is “broadly accessible to patients.”

And they say the DRG should exclude clinical trials: “Since the cost of drugs are not factored into a case treated through a clinical trial, including clinical trials involving CAR T in payment rate determination skews the true cost. Payments for CAR T must be set solely for non-clinical trial cases in order to accurately capture the price,” AAF explained.

Health care CEOs have chimed in, calling for a “stable reimbursement model” that adequately reimburses hospitals “so they may continue to deliver innovative, lifesaving cancer therapies.”

And a former CAR T patient explained in a recent op-ed how the “clinically proven, innovative option” saved his life—and Medicare patients should have the same opportunity.

What they’re saying: “When I was out of options, CAR T therapy gave me back my life. Everyone deserves the same opportunity. Patients’ locations and coverage—whether Medicare or not—should not dictate who can be treated with potentially lifesaving therapies,” concluded Dr. Brian Koffman.

BIO’s Take: BIO has long advocated for the creation of a specific payment code for CAR T-cell therapies so America’s seniors can access this groundbreaking cancer treatment—a model that would set the stage for other transformative medicines in the pipeline, too.

 

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Mazda zooms ahead to biofuel-powered cars

You might be driving an algae-powered car soon, thanks to Mazda. Here's the scoop.

The plan: Working with industry and academia, Mazda is investing in algae-based biofuels research, because renewable liquid fuel will be “essential to drastic carbon dioxide reduction” in transportation, reports Bioenergy International.

The goal: The company wants to reduce its carbon emissions to 50 percent of 2010 levels by 2030 and 90 percent by 2050.

Why biofuels? “[W]hen burnt, algae biofuel only releases CO2 recently removed from the atmosphere via photosynthesis as the algae grew,” explains Mazda. “Algae fuels can be farmed on land unsuitable for agriculture, can be grown with minimal impact on freshwater resources, can be produced using saline and wastewater, have a high flash point, and are biodegradable and relatively harmless to the environment if spilled.”

BIO continues to support low-carbon fuel initiatives across the United States—and initiatives like this one can help bring biofuels into wider use, helping to clean up the air and support renewable energy jobs at a time when we need it the most.

 
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President Trump’s Tuesday: Meeting with recovered COVID-19 patients and health care executives today. The Coronavirus Task Force is scheduled to hold a press briefing at 5pm ET.

What’s Happening on Capitol Hill: Coronavirus recess, which is likely to be extended until at least May 4. House Democrats are sharply criticizing Trump’s plans to reopen the economy, while Senate Republicans plan to look into the origins of the coronavirus. And nearby, the Supreme Court will hear oral arguments by phone—and allow the public to dial in, too.

 
 
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