Closing the readiness gap for CGTs in community-based care

The next phase of CGT access  

For many CGTs today, a small number of academic medical centers remain the primary path to treatment. These centers play a critical role in the early phases of adoption. They have the infrastructure, specialized staff, and experience needed to support highly controlled rollout models. 

But that model alone may not be enough going forward. 

Biopharma companies are increasingly focused on expanding access beyond these few early-adopter environments and into the many hospitals in community settings. If CGTs are to reach more patients, care delivery must extend closer to where many patients already receive treatment.  

For example, oncology patients often begin their treatment journey with a community oncologist. By the time they are eligible for a cell therapy, they may have already gone through multiple lines of treatment. They may be clinically vulnerable, financially strained, and reluctant to travel far from home for care. 

There is also a capacity issue. Academic medical centers alone may not be able to absorb the level of patient volume many manufacturers expect as more therapies move toward launch and broader adoption. Expanding CGTs to non-academic health systems and community sites of care is becoming a commercial necessity.

Scientific readiness surpasses operational readiness 

Unfortunately, cell and gene therapies are advancing faster than the delivery models needed to support them in broader care settings. That gap is especially visible in community hospitals, where operational processes may still be lagging, financially risky, or difficult to scale for CGTs. Even when hospitals are clinically motivated to participate, activation can stall when teams have to coordinate staff training, referral workflows, reimbursement, product handling, chain-of-custody documentation, and patient scheduling.  

As a result, biopharma companies may find that only a limited number of community sites are truly launch-ready. If these barriers are not addressed, the impact can be significant and result in: 

• Slower launch uptake 
• Inconsistent product access 
• Greater strain on health system partners 
• More difficulty sustaining long-term adoption 

Common barriers to community-based CGT expansion 

Based on what our partners are seeing in the market, several barriers stand out. 

1. Onboarding can take longer than teams expect 

Standing up new community sites for a CGT often requires far more than clinical alignment. Operational execution can become a bottleneck. Biopharma companies and hospitals may need to work through: 

• Contracting and terms and conditions 
• Credit checks and credit limit decisions 
• Internal workflow setup 
• Staff education and cross-functional coordination 

These steps can take months. The challenge is often greater for emerging biopharma companies launching a CGT for the first time. Many do not yet have the internal playbooks, staffing models, or launch infrastructure that could expedite site onboarding. At the same time, many community hospitals lack CGT-specific operational experience. Without a clearer path to activation, site expansion can stall before treatment even begins. 

2. Financial exposure is real for community hospitals

Financial risk is another major factor. CGTs carry a high upfront cost, and hospitals may face significant exposure when therapy is purchased, delivered, or staged before final access or administration is complete. If scheduling delays, product access issues arise or logistics disruptions occur, expensive inventory may remain on site longer than expected.

That creates real balance-sheet pressure for health systems. For hospitals in community settings, that risk can be enough to slow or limit program participation — even when there is clinical interest and patient need.

Biopharma companies looking to expand their footprint need to think beyond product distribution alone. They should consider models that reduce the financial burden on hospital partners and create a more workable path to adoption.

3. The patient and caregiver experience can become a barrier of its own

Even when a community site is operationally enabled, the patient journey can still be difficult to navigate. Being treated with a CGT often involves complex logistics and ongoing coordination, which can become burdensome if the orchestration of services and staff is fragmented. In many cases, patients and caregivers absorb a large share of these burdens themselves, dealing with: 

• Scheduling delays 
• Administrative complexity 
• Coordination across multiple stakeholders 
• Post-infusion support and monitoring needs 

For some therapies, caregivers may need to be available around the clock for a defined period after infusion. Not every patient has that level of support.  

These realities can delay therapy initiation. In some cases, they may discourage patients from moving forward at all. For manufacturers, that means access to these therapies is not just about site activation. It is also about reducing friction across the treatment journey. 

What this means for CGT launch teams 

The gap between scientific ambition and real-world execution is widening. CGT pipelines are accelerating. At the same time, health systems are managing operational, financial, and patient-related friction that can make expansion difficult — especially outside major academic centers. 

For commercial leaders, the implication is clear: if manufacturers do not find ways to support adoption in hospitals and community settings, they may struggle to reach the patient volumes needed to achieve both market potential and patient impact. Launch planning should account for the realities of community expansion earlier, more deliberately, and with the right operational support in place. 

A more connected model for launch readiness 

Biopharma companies preparing for commercial launch often need more than strategic advice alone. They need partners with proven experience connecting access, distribution, site readiness, and patient coordination at scale. As CGTs move into their next commercial phase, success will depend not only on the strength of the therapy but also on the strength of the systems that support it. 

Cencora works across the healthcare ecosystem, with relationships spanning CGT manufacturers and provider networks, including community care providers. That vantage point provides visibility into the pressures that launch teams and sites of care are navigating as they work to responsibly expand product access. 

Contact our team to learn how Cencora can help address the operational, financial, and product access challenges shaping CGT launch success.