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Chimeric antigen receptor T cell therapy (CAR-T cell): guidelines for costing, counting and reconciliation of funding18 June 2020
The guidelines set out the scope, funding, costing, counting and reconciliation of funding for the chimeric antigen receptor T cell therapy (CAR-T cell) immunotherapy program using the Novartis CAR-T product Kymriah. The CAR-T program is for paediatric and young adults (up to 25 years) with Acute Lymphoblastic Leukaemia (ALL) who relapse or do not respond to initial therapy.
There is a growing discussion in Australia and internationally about the need to increase focus on delivering value-based health care with a focus on patient outcomes and experience.
IHPA’s Pricing Guidelines and the National Health Reform Agreement include provisions for IHPA to consider the impact on its work of evidence‑based, effective new technologies and innovations in models of health care.
Bundled pricing is where a single price covers a full package of care over a defined period of time, spanning multiple events and settings of care. The intention is for resources and funding to be easier for hospitals to manage, to allow financial flexibility to encourage improved models of care or greater standardisation of evidence-based care, and drive better service delivery in the long run which should lead to better patient outcomes and lower costs.
This guide is intended to provide assistance when assigning care types, especially for those patients that may potentially have care that applies to more than one care type.