Chimeric antigen receptor-T cell therapy manufacturing: modelling the effect of offshore production on aggregate cost of goods.

Cell and gene therapies have demonstrated excellent clinical results across a range of indications with chimeric antigen receptor (CAR)-T cell therapies among the first to reach market. Although these therapies are currently manufactured using patient-derived cells, therapies using healthy donor cells are in development, potentially offering avenues toward process improvement and patient access. An allogeneic model could significantly reduce aggregate cost of goods (COGs), potentially improving market penetration of these life-saving treatments. Furthermore, the shift toward offshore production may help reduce manufacturing costs. In this article, we examine production costs of an allogeneic CAR-T cell process and the potential differential manufacturing costs between regions. Two offshore locations are compared with regions within the United States. The critical findings of this article identify the COGs challenges facing manufacturing of allogeneic CAR-T immunotherapies, how these may evolve as production is sent offshore and the wider implication this trend could have.

[1]  Bruce L. Levine,et al.  Global Manufacturing of CAR T Cell Therapy , 2016, Molecular therapy. Methods & clinical development.

[2]  Vinay Prasad,et al.  Immunotherapy: Tisagenlecleucel — the first approved CAR-T-cell therapy: implications for payers and policy makers , 2018, Nature Reviews Clinical Oncology.

[3]  Jan de Boer,et al.  Translational regenerative medicine , 2007 .

[4]  Nicholas Medcalf,et al.  Cell therapy-processing economics: small-scale microfactories as a stepping stone toward large-scale macrofactories. , 2018, Regenerative medicine.

[5]  Sheng Lin-Gibson,et al.  Manufacturing Cell Therapies: The Paradigm Shift in Health Care of This Century , 2017 .

[6]  Bo Kara,et al.  The translation of cell-based therapies: clinical landscape and manufacturing challenges. , 2015, Regenerative medicine.

[7]  K. Roy,et al.  Perspectives on Manufacturing of High-Quality Cell Therapies. , 2017, Molecular therapy : the journal of the American Society of Gene Therapy.

[8]  P. O'Neill,et al.  An analysis of supply chain strategies in the regenerative medicine industry—Implications for future development , 2014 .

[9]  Qasim A Rafiq,et al.  Decentralised manufacturing of cell and gene therapy products: Learning from other healthcare sectors. , 2018, Biotechnology advances.

[10]  J. Kurtzberg,et al.  Current perspectives on the use of ancillary materials for the manufacture of cellular therapies. , 2016, Cytotherapy.

[11]  P. Hari,et al.  Closed-system manufacturing of CD19 and dual-targeted CD20/19 chimeric antigen receptor T cells using the CliniMACS Prodigy device at an academic medical center. , 2017, Cytotherapy.

[12]  Scott Gottlieb,et al.  Balancing Safety and Innovation for Cell-Based Regenerative Medicine. , 2018, The New England journal of medicine.

[13]  E. Blyth,et al.  Low-cost generation of Good Manufacturing Practice-grade CD19-specific chimeric antigen receptor-expressing T cells using piggyBac gene transfer and patient-derived materials. , 2015, Cytotherapy.

[14]  Q. Rafiq,et al.  Centralised versus decentralised manufacturing and the delivery of healthcare products: A United Kingdom exemplar. , 2018, Cytotherapy.

[15]  Q. Rafiq,et al.  Decentralized manufacturing of cell and gene therapies: Overcoming challenges and identifying opportunities. , 2017, Cytotherapy.

[16]  S. Dhanjal,et al.  Development and production of good manufacturing practice grade human embryonic stem cell lines as source material for clinical application. , 2016, Stem cell research.

[17]  C. Hewitt,et al.  Culture of human mesenchymal stem cells on microcarriers in a 5 l stirred-tank bioreactor , 2013, Biotechnology Letters.