As Co-Chairs of CAR T Vision*, we’ve been proud to see momentum building as more members join us around a shared understanding of the transformative potential of CAR T-cell therapy. This international coalition aims to unite stakeholders across healthcare, advocacy, research, and policy around a shared, collaborative ambition: to double the proportion of eligible patients treated with CAR T-cell therapy by 2030 and, ultimately, for every eligible patient to get the opportunity for a cure with CAR T-cell therapy. This clarity of purpose is reinforced by our belief that the pace of innovation, collaboration, and commitment across the cell-therapy ecosystem makes the target of doubling patient access by 2030 a realistic and achievable goal.
Since the launch of CAR T Vision at ASCO earlier this year, our independent Steering Committee has seen an increase to 15 leaders, with new members George Eastwood, Executive Director, Emily Whitehead Foundation; Christine Pfaff, Director of Clinical Initiatives, Community Oncology Alliance (COA); and Dr Noopur Raje, Director, Center for Multiple Myeloma, Massachusetts General Hospital. These additions further bolster the Committee’s expertise with valuable insights from more disease areas, community settings, and policy and payor institutions.
To date, the CAR T Vision and its roadmap report have been endorsed by 12 leading organizations, including Alliance for Regenerative Medicine (ARM), Foundation for the Accreditation of Cellular Therapy (FACT), Barts Cancer Institute, and Catapult Cell and Gene Therapy, demonstrating the consensus around its goals. For us, this growing coalition reflects a shared sense of purpose to prioritize patient equity and access to therapeutic innovation.
To translate CAR T Vision into concrete, measurable actions, we’ve established three Working Groups comprised of Steering Committee members and more than 40 additional subject matter experts. Together they’re working to develop specific indicators and calls to action that will help address CAR T-cell therapy access challenges and drive meaningful change across the three policy imperatives of the Vision’s goal. This measurement framework, developed with input from Working Group members, is being finalized during the ASH Annual Meeting and Expo, and we intend to roll it out in early 2026. This output represents the next critical step in transforming ambition into action, and action into measurable progress.
Barriers to CAR T-cell Therapy
To understand why our goal matters so profoundly, we must first look at the reality patients face today. Over the past ten years, CAR T-cell therapy has represented one of the most transformative, potentially curative advances in cancer treatment. Today, hundreds of clinical trials are underway to explore CAR T-cell therapies for other serious conditions, including solid tumors (cancers), HIV, and autoimmune diseases.[1][2][3][4][5] For some patients with certain forms of aggressive and difficult-to-treat blood cancers, CAR T-cell therapies have enabled them to remain cancer-free for more than five years.[6][7][8][9] And as more patients are treated with CAR T-cell therapy across the world, our understanding of the treatment is also expanding: one real-world study (n=551) found that the median overall survival with CAR T-cell therapy in older adults over 75 was comparable to that in younger patients.[10]
Although it has been available in the United States for certain blood cancers for seven years, there is still limited access to this potential life-saving treatment. Only about two out of 10 eligible patients in the U.S. and in Europe receive access to CAR T-cell therapy.[11][12]
Challenges are complex, many and varied, [13][14] and include referral delays,[15] limited treatment center capacity, [7] limited knowledge across clinicians and patients,[16] travel and financial burdens,[7] and funding and reimbursement challenges. [8]. Because any small delay can affect patient outcomes, these complex challenges risk leaving behind patients who stand to benefit from these treatments. These issues are further compounded by the complexity of delivering CAR T-cell therapy, which requires highly specialized infrastructure and multidisciplinary coordination.
More can be done for these patients, and this is why the CAR T-Vision initiative was formed, with an ambitious goal that reflects both the urgency for change at scale and with a focus on three key policy imperatives:
Increasing awareness and understanding of CAR T-cell therapy is essential so that healthcare professionals (HCPs) are able to identify eligible patients earlier and refer them to specialists, while ensuring they and their caregivers understand the benefits, risk, and logistical and financial considerations.[17] A 2024 IQVIA Institute analysis covering seven countries (Australia, Canada, France, Germany, Italy, Spain, and the United Kingdom) found that ~70% of referring physicians stated they would benefit from more, or a lot more, information about CAR T-cell therapy.[18]
Growing understanding would also allow policymakers and payors to recognize the value in CAR T-cell therapy, so that they can work with stakeholders to address systemic barriers. This collective understanding supports the principle that timely identification of eligible candidates and initiation of referrals is essential to ensuring optimal outcomes for patients.
Expanding resources and capacity to relieve the bottlenecks that can cause delays in referrals and treatment. This requires decentralized delivery models to bring care closer to patients, and formalized processes for coordination and communication between referral and treatment centers. Patients who don’t live near a CAR T center are less likely to be treated with CAR T-cell therapy, and in that situation, they will be looking at treatment options that have less curative impact. One study found the likelihood of receiving a CAR T-cell therapy was reduced by 40% when patients lived two to four hours from their nearest treatment center.[19]
It also includes harmonized manufacturing requirements, as some commercial manufacturers conduct their own inspections [20] to authorize a center to provide a treatment, with the criteria for these inspections sometimes differing between manufacturers and products. Also required are streamlined qualification processes for treatment centres, and forecasting and demand planning processes that support staff and expand capacity. These efforts can be strengthened by hub-and-spoke frameworks, or satellite models, that enable shared responsibilities and streamlined referrals, and by broader advances in decentralization, workforce development, and digital infrastructure, addressing systemic access barriers.
Developing sustainable and innovative financing approaches is critical to managing the costs of treatment and care. As more CAR T-cell therapies in different indications become available, it is essential that reimbursement and payor methodologies keep pace with this innovation and that there are innovative, sustainable funding sources to cover the full cost of treatment and care in a timely way for all eligible CAR T-cell therapy patients. This includes establishing economic models that reflect the upfront budget impact of CAR T-cell therapy, which can be mitigated in the long term through reductions in healthcare spending.
It also requires real-world data to support decision-making on the clinical and economic value of CAR T-cell therapy, and innovative and sustainable contracting models to ensure patients have access to innovative treatments now and more as they become available. It also depends on timely reimbursement that covers the full cost of hospital treatment and care. In the US, current reimbursement rates may leave some treatment centers with financial losses [21], which could disincentivize them to offer CAR T-cell therapy as a treatment option. And across the European Union, there are differences in reimbursement schemes between the different Member States. In some countries, the associated costs of pre- and post-care are not reimbursed sufficiently.[22]
Through reductions in the total cost of care, expanded access, and innovative financing partnerships, the long-term sustainability of CAR T-cell therapy can be assured.
Call to action
Creating a future where every eligible patient has the opportunity for a cure with CAR T-cell therapy involves a complex ecosystem of partners, each with their own unique role to play in making the CAR T Vision a reality. We call on patient and caregiver organizations, HCPs, payors, HTA bodies, regulators, policymakers, legislators, and industry, to consider how you can also contribute to joint efforts to ensure more eligible patients get access to CAR T-cell therapy in the next five years. Together, we can double the number of eligible patients treated by 2030 and bring the promise of a cure to many more patients.
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Note:* The CAR T Vision is for every eligible patient to have the opportunity for a cure with CAR T-cell therapy. By 2030, the aim is to double the proportion of eligible patients treated with CAR T-cell therapy. The CAR T Vision Steering Committee includes leadership from top North American and European patient advocacy groups, medical societies, academic and community treatment centers, health technology assessment, policy, and other subject-matter experts. The new roadmap report details the challenges CAR T Vision aims to resolve through multidisciplinary collaboration and the urgent actions needed to make the Vision a reality.
Reference
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[22] European Cancer Patient Coalition. CAR-T Therapy White Paper. 2022. Available online: https://ecpc.org/wp-content/uploads/2022/11/WhitePaper-CAR-T-therapy.pdf
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DOI:10.14229/onco.2025.12.03.001
