The High Cost of “Living Drugs”: Why Making Cancer Cell Therapies Affordable Remains a Global Challenge

CAR-T and other cell therapies are fundamentally different from traditional pharmaceuticals. Instead of being mass-produced chemical compounds, they are individualized treatments involving the extraction, genetic modification, expansion, and reinfusion of a patient’s immune cells. Each step requires specialized facilities, highly skilled labor, and strict quality controls. This bespoke manufacturing process drives production costs far higher than those of conventional drugs, with single treatments often priced between US$300,000 and US$500,000 in major markets. Even as more therapies gain regulatory approval, economies of scale remain limited because each batch is tied to a specific patient.

Efforts to reduce costs have focused heavily on manufacturing innovation. Biopharmaceutical companies and research institutions are investing in automated production lines, standardized cell-processing platforms, and allogeneic “off-the-shelf” cell therapies derived from healthy donors rather than individual patients. These approaches aim to shorten production cycles, reduce labor intensity, and increase throughput. However, allogeneic therapies introduce new scientific and regulatory risks, including immune rejection and long-term safety concerns, which have slowed commercialization despite promising early trial results.

Reimbursement systems present an additional challenge. Many healthcare systems were designed to pay for chronic treatments administered over time, not one-off therapies with high upfront costs but long-term benefits. Insurers and public payers struggle to justify immediate six-figure payments, especially when patient outcomes can vary. Innovative payment models such as outcome-based reimbursement, installment payments, and risk-sharing agreements have emerged, but adoption remains uneven. In lower- and middle-income countries, limited insurance coverage and constrained public healthcare budgets further restrict access to these therapies.

China has emerged as a critical testing ground for affordability strategies. The country hosts one of the world’s largest pipelines of CAR-T candidates, supported by lower clinical trial costs and a growing domestic biotech ecosystem. Some Chinese developers are pursuing lower-cost manufacturing models and faster development timelines, aiming to deliver therapies at a fraction of Western prices. However, regulatory tightening and concerns over quality and long-term efficacy have slowed approvals, highlighting the trade-off between speed, safety, and affordability.

Ultimately, making “living drugs” affordable will require coordinated progress across science, manufacturing, regulation, and healthcare financing. While technological advances may gradually lower costs, the fundamental complexity of personalized medicine suggests that cell therapies are unlikely to become cheap in the near term. The challenge for governments, insurers, and drugmakers is to design systems that balance innovation incentives with broader patient access, ensuring that breakthroughs in cancer treatment do not remain accessible only to a privileged few.