Restoring Patient Agency: Breaking the 80% Access Barrier in Cell Therapy | Michelle Hill

In this episode of Out of the Lab, host Nico Crudele sits down with Michelle Hill, a 30-year biotech veteran, Kite Gilead alum and founder of Avenue to Care, to examine why revolutionary cell therapies like CAR T are failing to reach over 80% of eligible patients. Michelle breaks down the severe non-clinical, operational, and socioeconomic barriers keeping advanced treatments locked behind elite academic medical centers. From community physician referral gaps and geographic attrition to building data-neutral care orchestration platforms, this conversation explores how the industry can bridge the gap between treatment availability and true patient access. Key Takeaways: Why CAR T adoption has plateaued at 20% and how current access disproportionately favors patients with health literacy and financial means. How general oncologists' lack of familiarity with cell therapy risks and successes creates early patient drop-outs. The role of non-clinical care orchestration in restoring patient agency without crossing pharma compliance boundaries. Navigating post-treatment survivorship, long-term follow-up registry demands (CIBMTR), and the impact of REMS updates on patient travel requirements. Timestamps & Key Topics: 00:00:00 – Introduction & Method Made Sponsor 00:01:16 – The 80% Access Deficit & Infrastructure Gaps 00:03:32 – The 10-Mile Rule & Geographic Attrition 00:06:26 – Early Diagnoses & The Loss of Patient Agency 00:11:32 – Rare Disease, Autoimmune, and the CAR T Horizon 00:14:07 – General Oncologist Referral Hesitancy & Perceived Failures 00:17:03 – Socioeconomic Privilege in Clinical Access 00:22:17 – Introducing Avenue to Care: Public Benefit Care Orchestration 00:26:34 – Post-Treatment Care, Survivorship, & Long-Term Data Tracking 00:31:07 – Global Access Challenges & Health Literacy 00:35:12 – Rebuilding Healthcare Around the Patient