Browse by author
Lookup NU author(s): Professor Edward MeinertORCiD, Dr Aidong Yang
This is the authors' accepted manuscript of an article that has been published in its final definitive form by Elsevier BV, 2021.
For re-use rights please refer to the publisher's terms and conditions.
© 2020 International Society for Cell & Gene Therapy. Background aims: Decentralized, or distributed, manufacturing that takes place close to the point of care has been a manufacturing paradigm of heightened interest within the cell therapy domain because of the product's being living cell material as well as the need for a highly monitored and temperature-controlled supply chain that has the potential to benefit from close proximity between manufacturing and application. Methods: To compare the operational feasibility and cost implications of manufacturing autologous chimeric antigen receptor T (CAR T)-cell products between centralized and decentralized schemes, a discrete event simulation model was built using ExtendSIM 9 for simulating the patient-to-patient supply chain, from the collection of patient cells to the final administration of CAR T therapy in hospitals. Simulations were carried out for hypothetical systems in the UK using three demand levels—low (100 patients per annum), anticipated (200 patients per annum) and high (500 patients per annum)—to assess resource allocation, cost per treatment and system resilience to demand changes and to quantify the risks of mix-ups within the supply chain for the delivery of CAR T treatments. Results: The simulation results show that although centralized manufacturing offers better economies of scale, individual facilities in a decentralized system can spread facility costs across a greater number of treatments and better utilize resources at high demand levels (annual demand of 500 patients), allowing for an overall more comparable cost per treatment. In general, raw material and consumable costs have been shown to be one of the greatest cost drivers, and genetic modification-associated costs have been shown to account for over one third of raw material and consumable costs. Turnaround time per treatment for the decentralized scheme is shown to be consistently lower than its centralized counterpart, as there is no need for product freeze-thaw, packaging and transportation, although the time savings is shown to be insignificant in the UK case study because of its rather compact geographical setting with well-established transportation networks. In both schemes, sterility testing lies on the critical path for treatment delivery and is shown to be critical for treatment turnaround time reduction. Conclusions: Considering both cost and treatment turnaround time, point-of-care manufacturing within the UK does not show great advantages over centralized manufacturing. However, further simulations using this model can be used to understand the feasibility of decentralized manufacturing in a larger geographical setting.
Author(s): Lam C, Meinert E, Yang A, Cui Z
Publication type: Article
Publication status: Published
Journal: Cytotherapy
Year: 2021
Volume: 23
Issue: 5
Pages: 433-451
Print publication date: 01/05/2021
Online publication date: 02/03/2021
Acceptance date: 16/08/2020
Date deposited: 24/07/2024
ISSN (print): 1465-3249
ISSN (electronic): 1477-2566
Publisher: Elsevier BV
URL: https://doi.org/10.1016/j.jcyt.2020.08.007
DOI: 10.1016/j.jcyt.2020.08.007
PubMed id: 33674239
Altmetrics provided by Altmetric
