Geographic Distribution Creates Disparities in Access to MM CAR T Care Centers

Key Takeaways:

• Multiple myeloma (MM) chimeric antigen receptor (CAR) T care centers are unevenly distributed across the US, with most centers located in urban areas. This forces patients living in larger states and rural areas to travel further on a regular basis to receive treatment.
• Most counties in the US are less than 120 minutes away from the nearest CAR T center, though only 22% of counties are located within 60 minutes from a center. Additionally, 18% of the population must travel over 2 hours to reach a center.
• Areas with higher access barriers tend to represent minority or socially vulnerable populations. Patients with high social vulnerability are 42% more likely to travel over 120 minutes to access a CAR T center.
• Policy reform and MM research is needed to improve CAR T therapies and reduce access disparities in order to make treatment for MM more equitable.

CAR T cell therapies have improved clinical outcomes and prolonged survival for patients with MM. However, these treatments are expensive and require travel to specialized centers. Thus, many disparities exist that bar patient access to CAR T-cell therapies, particularly for socially vulnerable and rural populations.

A geospatial analysis of access to MM CAR T centers explored the various disparities in MM care and identified key underserved populations and regions. Based on these findings, the authors provided suggestions to make CAR T care more equitable and accessible.

CAR T Centers Disproportionately Distributed Across Geographic Regions

The study identified a total of 256 CAR T care centers across 44 states and 87 counties in the US. The majority of these centers (98.5%) were located in urban areas, meaning patients in rural areas had a higher travel burden than those in cities.

Regional distribution across the US remained even: 25% of the centers were located in the Northeast, 24% in the Midwest, 31% in the South, and 20% in the West. However, access was higher in the Northeast and Midwest than in the South and West regions.

Patients in larger states, lower-populated areas, and rural locations had higher difficulty accessing a center. States such as Nevada, Utah, and Idaho are bigger regions but have only 1 care center. Patients living in the Mountain West, rural West Coast, Great Plains Region, and Rio Grande Valley had to travel further distances to access a CAR T center.

Drive Time Distance Presents a Significant Barrier to Access

The study analyzed the time drive distance of 3144 US counties. Only 705 (22%) counties were less than 60 minutes from an MM CAR T care center, representing 59% of the population. Most counties (40%) were located between 60 and 120 minutes from a center and represented 23% of the population. A total of 1168 counties (18% of the population) were over 120 minutes away from a center.

These findings showcase that a significant portion of patients with MM in the US would need to either regularly commute long distances or temporarily relocate closer to CAR T centers to receive treatment. The analysis also reveals drive time distance as a high burden and primary barrier to care for patients and caregivers alike.

Access Further Inhibited by Socioeconomic Status

Geographic areas exhibiting lower access tended to have lower socioeconomic status and represent underserved minority populations as well.

Regarding proximity to CAR T centers, counties located less than 2 hours away from a center were mostly urban areas with 80% of residents identifying as a minority. Counties located over 120 minutes from a center had more socially vulnerable populations and represented 20% of US minorities. Patients with high social vulnerability were 42% more likely to travel over 120 minutes to access a CAR T center.

Improving Access to CAR T Centers

The study’s authors note that addressing these disparities are “[o]f particular importance as multiple studies have shown that timely access to MM CAR-T directly correlates to CAR-T clinical outcomes and that delays in CAR-T availability has a direct relationship to MM mortality.”

The authors call for policies and resources that would make access more equitable, such as reimbursing transportation and housing costs and providing coverage for lower-income and socially vulnerable patients. Investing in MM research and improving CAR T technologies could help patients overcome geographic disparities by reducing the need to travel altogether.

Reference

Daunov M, Gorham BR, Lytvynova O, et al. Disparity in access to multiple myeloma CAR-T: A geospatial analysis of distance to CAR-T centers. Blood Immunol Cell Ther. 2026:100064. doi:10.1016/j.bict.2026.100064