Survey: 40% of Community Practices Offer or Plan Cellular Therapy

Forty percent of respondents to a new Community Oncology Alliance (COA) survey reported that their practices are currently offering or planning to offer cellular therapies, such as chimeric antigen receptor (CAR) T-cell therapy, to eligible patients in 2026 or 2027. Inconsistent insurance coverage and upfront program costs were the barriers cited most often.¹ According to COA, the results describe the participating respondents and should not be interpreted as national prevalence estimates.

How was the COA Cellular Therapy Survey conducted?

COA conducted the 2026 COA Cellular Therapy Survey over 4 weeks in July and August 2026, distributing it through its Board of Directors, the Community Oncology Pharmacy Association (COPA), and the COA Administrators' Network.¹ Fifty individuals responded, including 47 who identified themselves as working in independent community oncology practices. Respondents represented a range of clinical and administrative roles and reported locations in 29 states; not all respondents identified their state.

Responses described practices preparing to launch outpatient CAR T-cell therapy programs. CAR T-cell therapy modifies a patient's own immune cells in a laboratory to help them recognize and attack cancer cells. According to the release, practices are working with apheresis partners to collect cells and with hospital partners to provide access to acute care management of adverse events after infusion, should they occur.¹

What barriers did community practices report?

Respondents reported the following barriers to offering cellular therapy¹:

• Inconsistent insurance coverage: 54%
• Upfront program costs: 52%
• Time-intensive single-case agreements with insurers: 44%
• Accreditation requirements: 40%
• Monitoring patients after hours and on weekends: 38%

The financial picture differs from that of other in-office therapies. Unlike chemotherapy or bispecific therapies, which are administered on a weekly or biweekly basis, cellular therapy is typically a single dose that can cost around $500,000, Christine Pfaff, RPh, MBA, director of clinical initiatives at COA, explained in an interview with The American Journal of Managed Care (AJMC) at the 2026 COA Payer Exchange & Innovation Summit, where she moderated a session reviewing the survey results.² Practices also need hospital partners for acute adverse event management, including intensive care unit beds, tocilizumab (Actemra), and neurology and infectious disease support, she said.

What support would help practices build cellular therapy programs?

When asked what support would help their practices build or maintain a program, approximately 76% of respondents selected fair product coverage and reimbursement, and 71% selected reimbursement for patient navigation and monitoring.¹ Respondents also identified financial planning tools, opportunities to learn from other community practices, and guidance on hospital and apheresis partnerships.

"Independent community oncology practices are committed to bringing innovative therapies to patients close to home, but coverage, reimbursement, and operational requirements must support their ability to provide this care," Pfaff said in the release.¹ "These findings point to a clear opportunity: supporting independent community oncology practices with workable coverage policies and the resources needed to deliver complex treatments can help bring innovation closer to the patients who need it."

How do the findings fit with broader community oncology trends?

The cellular therapy results follow a separate COA survey on bispecific therapy, in which 91.4% of 93 respondents reported that their practices already administer bispecific therapies in-office.^1,3 Oncology Nursing News has previously reported on how community oncology nurses built protocols to deliver bispecific antibodies locally, including scheduled follow-up calls with patients during the monitoring window, so patients could avoid traveling to tertiary centers.⁴ Academic programs have also moved CAR T-cell therapy closer to patients; in an August 2026 discussion, Joanna Rhodes, MD, MSCE, noted that Rutgers was weeks away from opening CAR T-cell therapy at 2 community sites.⁵

The survey has limitations. It included a small number of self-selected respondents reached through COA networks, and the release does not report how many practices currently have active cellular therapy programs vs plans to launch one, or any patient outcomes.

What are the key takeaways for oncology nurses?

• Build after-hours pathways: 38% of respondents cited after-hours and weekend monitoring as a barrier, so clear triage and escalation plans for patients and caregivers are central to new programs.
• Coordinate across partners: Practices rely on apheresis and hospital partners; nurses can help ensure patients know where to go if acute adverse events occur after infusion.
• Start financial navigation early: Inconsistent coverage (54%) and single-case agreements (44%) suggest benefits checks and authorizations should begin well before cell collection.
• Document navigation and monitoring work: 71% of respondents identified reimbursement for these services as needed support.
• Learn from peers: Respondents asked for opportunities to learn from other community practices that have launched programs.

References

1. Community oncology practices delivering innovative cancer treatment despite persistent barriers to access. News release. Community Oncology Alliance. October 28, 2026. Accessed October 28, 2026. https://mycoa.communityoncology.org/news-updates/press-releases/2026-cellular-therapy-survey

2. New models for cellular therapy delivery: Christine Pfaff, RPh, MBA. The American Journal of Managed Care. September 22, 2026. Accessed October 28, 2026. https://www.ajmc.com/view/new-models-for-cellular-therapy-delivery-christine-pfaff-rph-mba

3. COA survey finds high bispecific-therapy adoption among community oncology practices. News release. Community Oncology Alliance. September 21, 2026. Accessed October 28, 2026. https://mycoa.communityoncology.org/news-updates/press-releases/coa-survey-finds-high-bispecific-therapy-adoption-among-community-oncology-practices

4. Mann K. Community nurses bridge gap in delivering local bispecific antibody therapy. Oncology Nursing News. July 6, 2026. Accessed October 28, 2026. https://www.oncnursingnews.com/view/community-nurses-bridge-gap-in-delivering-local-bispecific-antibody-therapy

5. Evens A, Rhodes J. Advances in lymphoma care: experts breakdown CAR T-cell therapy, bispecifics, and CLL management. Oncology Nursing News. August 21, 2026. Accessed October 28, 2026. https://www.oncnursingnews.com/view/advances-in-lymphoma-care-experts-breakdown-car-t-cell-therapy-bispecifics-and-cll-management