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REMS Removed: Why CAR-T’s Expansion into Community Oncology Could Benefit the Big Three Wholesalers

REMS Removed: Why CAR-T’s Expansion into Community Oncology Could Benefit the Big Three Wholesalers

By Greis Kapexhiu and Adam J. Fein, Ph.D. In June 2025, the FDA announced that CAR-T therapies would no longer be subject to a REMS program. The FDA’s removal of CAR-T REMS requirements eliminates one obstacle to expanding treatment beyond traditional academic medical centers. That change could disproportionately benefit the Big Three wholesalers, which have spent billions building positions in community oncology while simultaneously investing in cell-and-gene-therapy distribution and support infrastructure. Read on for our review of this dynamic sector and ponder how wholesalers’ community oncology roll-up activities could interact with their cell and gene therapy (CGT) investments. Will wholesalers capture a growing share of CAR-T’s economics, or will hospitals continue to hold the upper hand? Read more »© 2006-2026 HMP Omnimedia, LLC d/b/a Drug Channels Institute, an HMP Global Company. All rights reserved. This Feed is for personal non-commercial use only.        

By Greis Kapexhiu and Adam J. Fein, Ph.D.

In June 2025, the FDA announced that CAR-T therapies would no longer be subject to a REMS program.

The FDA’s removal of CAR-T REMS requirements eliminates one obstacle to expanding treatment beyond traditional academic medical centers. That change could disproportionately benefit the Big Three wholesalers, which have spent billions building positions in community oncology while simultaneously investing in cell-and-gene-therapy distribution and support infrastructure.

Read on for our review of this dynamic sector and ponder how wholesalers’ community oncology roll-up activities could interact with their cell and gene therapy (CGT) investments. Will wholesalers capture a growing share of CAR-T’s economics, or will hospitals continue to hold the upper hand?
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