Opportunities, Challenges in the Democratization of Cell Therapy

Cell therapy is an active area of research, especially in the context of stem cells. This treatment had its breakthrough in 1960s, revolutionizing medicine and giving hope for some types of blood cancers such as leukemia, or blood disorders like anemia, among more than 75 other diseases. The potential benefits of cell therapy are manifold, and I have witnessed its impact in people's lives and in the clinical field.

Although cell therapy is a field that is constantly advancing, it continues to present particularly important challenges for its implementation, especially in Mexico. How can we as a community that seeks to promote the democratization of cell therapy, contribute to breaking down barriers? One critical way is by driving change through active participation in forums and events that reunite organizations, transplant centers, health professionals, insurance companies, and allies.

Recently I had the pleasure and honor of being part of the second edition of the NMDP Forum, a collaborative space between hematologists, oncologists, immunologists, and various health professionals, where we addressed the economic, social, cultural, and regulatory aspects that must be considered through a multidisciplinary perspective to give access to cell therapy more broadly. During this edition of the NMDP Forum, we centered on one topic: “Unrelated cell transplant, integral approach and multidisciplinary collaboration.” 

So, what are the priorities for progress toward democratization of cell therapy? Unrelated blood stem cell transplants are becoming increasingly visible; we have worked to facilitate access to them, diversifying and increasing the number of potential donors in the country. Steps have been taken toward the democratization of cell therapy, but there are several factors that still need immediate attention.

We need to seek to advance in the regulation and dissemination of this type of treatment among colleagues and health authorities because the harmonization of regulatory pathways is crucial to facilitate access to cell therapy treatments for patients in the country. We also outlined some of the advances that will help expand patient access to innovative, life-changing treatments like cell therapy, and how we address some of the challenges that prevent the widespread use of cell therapy, but focusing on our own industry is what will continue to pave the way. For example, insurance companies need to continue adapting to the specific challenges of cell therapies by implementing pathways to streamline evaluations.

Efforts to increase dialog between regulatory agencies, industry, and academia to standardize regulatory norms are also crucial. As the pipeline of cell therapy continues to expand, increased alignment of regulatory pathways will be decisive in bringing cell therapy closer to all the actors involved. 

It is necessary to continue strengthening the presence of the transplant centers, the organizations responsible for promoting and coordinating transplants, like those that are part of NMDP México®, formerly known as Be The Match® Mexico. One way is to implement more effective strategies to offer timely and efficient access to patients, continuing to involve the health system, and demanding the participation of various actors to move toward the democratization of cell therapy.

We need to act on developing policies that ensure financing and economic support for patients who require these treatments; therefore, efforts have been directed at strengthening the relationship with private insurers to integrate unrelated blood stem cell transplants into their coverage. 

Just to give a general overview, more than 2,000 transplants are required each year throughout the country, so it is necessary to continue working in solidarity with the government, civil society, organizations, and health institutions to strengthen efforts in favor of the culture of donation in our country. Patients who require a transplant face several obstacles on their way to treatment, such as difficulty in finding matches, prohibitive costs, medical complications, and administrative and legal barriers. From our position, we actively influence the general law to include as part of the legislation, the coverage of unrelated transplants, but what other initiatives can we promote from our sectors?

There is a general lack of knowledge about unrelated blood stem cell transplants in Mexico, including their scope, processes, and implications. In this context, physicians and social workers play a crucial role in the dissemination of information to patients.  

Cell therapy is undoubtedly a treatment option that is gaining momentum and has the potential to transform medicine into areas where there is still a significant need. We have the commitment and responsibility to continue fostering communication around the concept of living donation among more health professionals in order to raise interest, encourage them to learn more about unrelated transplants, and,  thus highlight the importance of talking about the culture of donation. From my standpoint, we need to focus on saving more lives through cell therapy and working as a multidisciplinary community to remove barriers around unrelated transplants. I am confident that by joining the efforts of all parties we will see noteworthy progress