CAR T-cell therapy system and patient journey

• Treatment with CAR T-cell therapy requires the coordination of a multi-disciplinary team including referring and treating physicians, nurses, pharmacists, along with the patients and their caregivers.
• Policy leaders are also key stakeholders as they shape the overall environment, fund these often-expensive treatments and can direct investments that focus on enhancing overall processes in the healthcare system.

Share of patients treated with CAR T-cell therapies among drug treated LBCL 2L+ R/R CAR T naïve patients (Evolution between 2022 and 2023)

• The overall share varies across countries. France had the highest share of patients receiving CAR T in 2023 with 30% and Italy the lowest (11%).
• Several factors can drive these differences in CAR T share such as the number of treatment centers, the processes for referrals and treatment initiation/ administration, and reimbursement dynamics.

Share of referring providers by level of information received about CAR T-cell therapy, Q2 2024

• Referring physicians in France, Australia, and Canada note a higher level of knowledge regarding CAR T-cell therapies compared to other countries in scope
• However, additional information and education programs may be beneficial in all countries with a substantial proportion of referring physicians noting the need for more information

Time between referral and commencement of CAR T treatment, Q2 2024

• The time between referral and commencement of CAR T treatment for DLBCL varies substantially across countries. Treating physicians in UK and Australia noted the highest proportion of times that were three months or greater
• Across all countries, there were a large proportion of cases that took two months. These delays after referral can be driven by capacity constraints and operational issues which need to be addressed.

Share of referred patients receiving CAR T treatment, Q2 2024

• An assessment of the share of referred patients receiving CAR T-cell treatment across countries for DLBCL in Q2 2024 highlights a higher proportion of patients being treated in Italy and Spain compared to other countries. This suggests that other countries may be facing additional challenges postreferral.
• It should be noted that while Italy has a high proportion of referred patients being treated, it has the lowest share of overall LBCL 2L+ patients receiving CAR T, highlighting that not all patients who may be eligible are referred and the referral process has been noted as a major barrier in Italy