From the perspective of a PhD trained cancer researcher, working on drug discovery/development in academia:
The cost might seem high. Some people think the cost is really going to make these types of cellular based therapy difficult to push into wide spread use. I'm more hopeful that new technology will drive down the cost in coming years. The techniques used to make these cells are years old at this point. That's just how long it takes to get things approved and trials conducted.
But remember the following:
1. This isn't (nor would you want it to be) front line therapy. It's for relapsed or non-responsive b-cell ALL. The side effect profile is risky, this therapy can kill a person, and there are life long implications to receiving it.
2. This is the first approved cellular therapy for wide spread use. It cost a massive amount of money to do the research and push this through the approval process. Billion of dollars for a product not very many people will get.
3. It isn't something that can be made and stored on a shelf. They take your cells out, process them, use a retrovirus to insert a new chimeric antigen receptor into them to target B-cells, and then reinfuse that into the patient. It's personalized medicine to the extreme.
3. The facilities to do what's listed in 2 are insanely costly to build and run, as their are extreme biosafety concerns when altering cells and putting them back into a person. The use of retroviruses makes the biosafety converses higher. Newer technologies will improve this aspect, but haven't been vetted and approved yet.
4. There would be many people involved in making these modified T cells, all of whom likely have masters degrees or PhDs. I'm not talking about the research side to develop them... but production. It's that involved.
5. This is in line with or in most cases cheaper than bone marrow transplants, which are fairly common for other cancers.
6. Novartis will only bill for the product if a patient shows a response within 30 days.
7. These patients have essentially few other options and would likely die without this therapy.