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In August 2017, the FDA approved the first–ever chimeric antigen receptor T cell (CAR–T) therapy for the use in terminally ill paediatric leukaemia patients. Today, this therapy, which genetically modifies a patient’s own immune cells to enable them to effectively detect and destroy cancer cells, is approved for use in rare subsets of paediatric leukaemia and adult lymphoma in the United States, the European Union, Switzerland, Japan, Canada and Australia. CAR–T therapy is unlike any traditional pharmaceutical product and requires innovation at every single step, from R&D to global patient access. This chapter gives an overview on the key inventive actions taken by the Novartis team in the past 24 months in bringing this product to market. A special focus is given to the novelty of a business model in which the pharmaceutical industry is no longer only a provider of medicines but acts as a treatment partner. Additionally, an in–depth perspective is provided on the value discussion of such one–time therapies with prolonged medical and clinical value and the different payment models pioneered in collaboration with healthcare systems and payers.