Ask most cell therapy investors what unlocks CAR-T's next phase of growth and you'll get an answer about the science: better constructs, allogeneic platforms, faster manufacturing turnaround, next-generation targets beyond CD19 and BCMA. All real, all worth funding, and none of it is the actual bottleneck.
CAR-T today is largely an academic medical center product: a handful of high-volume transplant and cellular therapy centers doing the apheresis, the bridging, the infusion, and the toxicity management that comes with it. That footprint made sense when the patient population was small and the infrastructure was experimental. It does not scale to where oncology actually happens, which is community cancer centers, where the overwhelming majority of patients in this country are treated.
BIO 2026's June 25 panel, "Bringing CAR-T to the Community," put exactly the right people in one room to make this point without saying it outright: Joe DePinto from McKesson's cell, gene and advanced therapies group, Rachel Haurwitz of Caribou Biosciences, Lynelle Hoch, who runs BMS's Cell Therapy Organization, and Ryan Metheny, who leads market access at Kite. That's a distributor, two manufacturers, and a market access lead sharing a stage to talk about expanding CAR-T beyond academic centers into the community.
"This is not a science problem being discussed by scientists. It's a distribution and access problem being discussed by the people who actually move product and manage reimbursement."
Reading the BIO 2026 panel composition as the thesis
And distribution problems in cell therapy are brutal in a way that doesn't show up in a target product profile. You're not shipping a vial with a two-year shelf life. You're managing a living cell product with a defined manufacturing slot, a cold chain that cannot fail, a turnaround clock that starts the moment apheresis happens, and a community oncology practice on the other end that has never handled a product like this, doesn't have the nursing infrastructure for cytokine release syndrome management that an academic transplant unit has built over a decade.
None of that is solved by a better CAR. It's solved by logistics, training programs, site-of-care partnerships, and manufacturing networks built to serve hundreds of community sites instead of forty academic ones. That is an infrastructure buildout, not a clinical development milestone, and it is expensive, unglamorous, and exactly the kind of work that gets treated as a post-approval operational detail instead of a strategic bet.
Most cell therapy companies today-manufacturing footprint, commercial team, distribution agreements-are still built for the old access model: a small number of sophisticated academic centers that already know how to handle the product. That model was right for a first-generation therapy proving itself in relapsed/refractory populations at specialized centers. It is the wrong model for a therapy trying to become standard of care at scale.
Decentralization readiness should be a diligence line item for cell therapy investment not something you evaluate after approval.
The contrarian diligence claim
When evaluating a cell therapy company, four questions separate real readiness from a slide in
a deck.
At Scimitar, Akira Robinson serves as Partner, Commercialization. He operates at the intersection of commercial strategy, launch execution, and market access, advising biopharma executive teams at critical moments where launch readiness directly determines asset value and time to market. With 20 years of experience across life sciences, diagnostics, biologics, and digital medicine, his work tackles complex commercial challenges for teams across the US and globally. His expertise spans the full commercial value chain—including launch planning, licensing, market access, pricing, analytics, marketing, sales distribution, and patient services across therapy areas, including: oncology, radiopharmaceuticals (RLT), rare disease, CNS, cardiology, and gastroenterology.
Our team of experienced life-science consultants collaborate with your team, from strategy development through implementation. By combining experience and innovation, Scimitar works with you to achieve proven results.
Contact Us