{"entity":{"id":"idea-reg-vein-to-vein-public-benchmark","kind":"idea","name":"Mandatory public reporting of vein-to-vein time and failure rate per CAR-T product","aka":[],"tldr":"Patients and doctors cannot see how long each CAR-T maker takes or how often manufacturing fails. Publishing this would create pressure to get faster and more reliable.","summary":"Vein-to-vein times for commercial CAR-T range from roughly three to eight weeks and out-of-specification rates from a few percent to over ten, but these figures appear only in trial publications and investor slides. The proposal is a regulatory condition that each approved cell therapy reports, quarterly and publicly, median and 90th percentile apheresis-to-infusion time, out-of-specification and manufacturing failure rates, and the proportion of enrolled patients never infused, stratified by country.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (Manufacturing cost and time for living and radioactive medicines): Hernandez, Prasad & Gellad, Total costs of chimeric antigen receptor T-cell immunotherapy (JAMA Oncology 2018)","url":"https://doi.org/10.1001/jamaoncol.2018.0977"}],"tags":[],"related":[],"cancers":[],"sections":[],"technologies":["car-t"],"targets":[],"drugs":["axicabtagene-ciloleucel","ciltacabtagene-autoleucel"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-manufacturing-cell-therapy","b-real-world-evidence"],"keyPapers":["paper-hernandez-jama-oncol"],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"Public benchmarking is followed by a fall in median vein-to-vein time of at least a week across the market within two years and convergence of failure rates towards the best performer.","rationale":"Public reporting of hospital outcomes and airline punctuality changed behaviour where private reporting did not. Manufacturers already collect these data for their own control; publication is cheap.","test":"Begin with voluntary reporting through a registry such as CIBMTR or EBMT, publish two years of data, and evaluate whether times and failure rates changed relative to the prior period.","maturity":"speculative","actor":"regulator","cost":"small","horizonYears":2},"route":"/ideas/idea-reg-vein-to-vein-public-benchmark/","neighbours":{"technology":[{"id":"car-t","kind":"technology","name":"CAR-T cell therapy","route":"/technologies/car-t/"}],"drug":[{"id":"axicabtagene-ciloleucel","kind":"drug","name":"Axicabtagene ciloleucel","route":"/drugs/axicabtagene-ciloleucel/"},{"id":"ciltacabtagene-autoleucel","kind":"drug","name":"Ciltacabtagene autoleucel","route":"/drugs/ciltacabtagene-autoleucel/"}],"bottleneck":[{"id":"b-manufacturing-cell-therapy","kind":"bottleneck","name":"Manufacturing cost and time for living and radioactive medicines","route":"/bottlenecks/b-manufacturing-cell-therapy/"},{"id":"b-real-world-evidence","kind":"bottleneck","name":"Weak real-world evidence and registries","route":"/bottlenecks/b-real-world-evidence/"}],"paper":[{"id":"paper-hernandez-jama-oncol","kind":"paper","name":"Total Costs of Chimeric Antigen Receptor T-Cell Immunotherapy","route":"/key-papers/paper-hernandez-jama-oncol/"}]}}