Cancer Advocacy Group of Louisiana (CAGLA) Chimeric Antigen Receptor T-Cell (CAR T-cell) Therapy Advocacy Update

The advocacy of CAGLA is built on the universal right to equitable and quality cancer care for all patients in Louisiana. The organization is an assembly of community leaders, physicians, and cancer survivors. The organization has a 100% success rate of passing Louisiana legislation. CAR T-cell therapy is genetically altered T-lymphocytes for patients with relapsed/refractory B cell leukemia/lymphomas or myeloma, improving their overall prognosis. CAR T-cell therapy cost of treatment alone exceeds 1.5 million dollars and is not covered by Medicaid in most states, leaving a vulnerable patient population without access to equal cancer care. CAGLA began advocacy for Medicaid covered CAR T-cell therapy in 2023.

March 30, 2023, CAGLA pre-filed house bill 435 sponsored by Rep. Aimee Freeman of Louisiana District 98. The proposed law requires Louisiana Medicaid coverage of inpatient and outpatient CAR T-cell therapy when used for an FDA approved indication and administered by a healthcare facility providing CAR T-cell therapy in accordance with state and federal guidelines/certifications. The law requires the healthcare facility appropriately providing CAR T-cell therapy must participate in the Louisiana Medicaid Program to provide CAR T-cell therapy to eligible enrollees. The law establishes the following requirements for a prospective enrollee to be considered eligible for CAR T-cell therapy enrollment: (1) the individual is enrolled in Louisiana Medicaid, (2) a licensed healthcare provider must certify CAR T-cell therapy is medically necessary and appropriate for the individual's condition, (3) the CAR T-cell therapy is administered in a facility appropriately providing CAR T-cell therapy in accordance with state and federal guidelines/certifications.

May 3, 2023, the proposed bill passed in the Louisiana House of Representatives (100 yeas/ 1 nay). June 4, 2023, the bill passed the Louisiana Senate (37 yeas/ 0 nay). June 8, 2023, the bill was signed by the President of the Senate. Then Louisiana Governor John Bel Edwards signed the bill June 12, 2023, and the law became effective August 1, 2023. Ochsner MD Anderson Cancer Center is the only adult CAR T-cell therapy program in Louisiana. Medicaid approved CAR T-cell treatment for a B-cell lymphoma Medicaid enrollee in January 2024. That patient was treated in April 2024, achieving complete remission.

As of October 2024, 72,058,701 children and adults were enrolled in Medicaid. States operate Medicaid, and coverage differences exist by state. Due to absence of coverage, this vulnerable patient population does not have equal access to cancer care due to discrimination by the costs of novel treatments. As a result of the advocacy efforts of CAGLA in 2023, Louisiana became the 7th state in the nation to provide Medicaid coverage of CAR T-cell therapy