Public-sector CAR-T manufacturing in India, Brazil and South Africa under $50,000
India has shown CAR-T can be made for a tenth of the US price. Public production in large middle-income countries could make it available to millions who are currently excluded.
NexCAR19 (ImmunoACT, Tata Memorial and IIT Bombay) was approved in India in 2023 at around $40,000; Brazil's Fiocruz and Butantan and China's academic centres are building comparable capacity. The proposal is a coordinated public-sector programme in three to five large middle-income countries with shared vector supply, shared training, a common product dossier adapted for national regulators, and outcome registries, aimed at treating relapsed B-cell malignancies at under $50,000 per dose within public health systems.
- Manufacturing cost and time for living and radioactive medicines · Cell therapies take weeks to make for one patient and cost hundreds of thousands of dollars. Isotopes run short.
- Most of the world has almost no cancer care · Seven in ten cancer deaths happen in low- and middle-income countries, where radiotherapy, pathology, surgery and drugs are scarce.
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