Adoptive Immunotherapy and Cellular Therapy

Aetna deems adoptive immunotherapy (e.g., TILs, LAK) and a broad range of cellular therapies experimental and investigational — and therefore not covered — for numerous indications (including many solid tumors, neurologic, cardiac, infectious, orthopedic and other conditions); CAR T‑cell therapy is specifically considered investigational for solid tumors. The policy does not apply to lifileucel for advanced melanoma, and the exclusion is based on these approaches lacking established effectiveness.

"No covered indications are explicitly listed in this CPB. The bulletin primarily designates adoptive immunotherapy and cellular therapy approaches described below as experimental and investigationa..."

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