Access to CAR-T therapies continues to show differences between countries, highlighting inequalities in the availability of these treatments. The MILenARI project aims to democratize this access among Mediterranean countries.
CAR-T therapies are treatments based on genetically modified immune cells designed to recognize and eliminate tumor cells. Since the first European approval in 2018, six CAR-T products have been authorized for different indications in lymphomas, leukemias, and multiple myeloma.
According to the data reviewed during the latest Advanced Therapies Seminar by Manel Juan, based on a study led by Julio Delgado that collected evidence mainly up to August 2024 (and partially updated until April 2025), 26% of the countries analyzed did not have any commercially available CAR-T product. In contrast, 74% had at least one product available for lymphomas or leukemias, while only 16% had at least one CAR-T therapy reimbursed for multiple myeloma, reflecting significant inequalities in access across Europe.
The mentioned analysis on access to CAR-T therapies included 31 European countries and evaluated aspects related to treatment reimbursement, time to access, and availability of accredited centers.
The study also described differences between countries in the time required for treatments to become available after regulatory approval. In some countries, access occurs immediately, while in others, timelines are considerably longer. The authors identify treatment costs and logistical complexity as some of the main factors that may limit implementation. Among other aspects, the administration of these therapies requires specialized centers, specific manufacturing processes, and healthcare resources for patient monitoring and management of potential toxicities.
In this context, the analysis of differences in access across Europe provides a useful framework to reflect the challenges associated with implementing advanced therapies in different healthcare systems. The MILenARI project is framed within this context of cooperation between Mediterranean countries with diverse healthcare realities in the field of CAR-T and other advanced therapies, and aims precisely to strengthen collaboration between Mediterranean countries to improve knowledge, research, and wider availability of these therapies.
The input data and the associated table were extracted from the framework reported by Julio Delgado et al. (2025) published in ‘Hemasphere‘, entitled ‘The European CAR-T map—Current status and future directions to improve access to CAR T-cell therapy for hematologic malignancies’.
Last Update
20/05/2026
Next Med