Having followed the development of gene therapy over the past 15 years, I am excited to see it coming of age, with the first FDA approved therapy, Kymriah™, made available on August 30th of this year. Because gene therapies offer a potential cure, they represent a significant advancement that is invaluable to patients. However along with this innovation comes a considerable barrier – extremely high cost.
There are 1500 more therapies in the pipeline, and considering their potential cost, it will be crucial for manufacturers, payers, and other stakeholders to work together and devise innovative solutions to help patients have access to these treatments. The article below touches upon financing approaches that may be considered. Regardless, payers will need to be more flexible in how they evaluate these therapies, while manufacturers will need to engage with payers earlier in the development process to ensure maximum patient access.
High Gene-Therapy Costs Trigger Call for New Payment Models Alex Philippidis The six-figure prices of new gene therapies will require payers, pharma companies, policymakers, and pharmacy benefit managers (PBMs) to develop new payment models that ensure patient access while reflecting the value delivered by the new treatments based on clinical outcomes, a top executive with PBM Express Scripts asserts. “Gene therapies will require payment and patient care systems that are as novel as the medications themselves,” Express Scripts CMO Steve Miller, M.D., wrote in a commentary posted online yesterday on the PBM’s blog.