FoCUS and NPC plan to explore Medicaid Best Price reforms required to enable precision financing solutions, including analyzing potential adverse effects on Medicaid.

The research will combine a review of stakeholder interviews with simulated economic modeling to develop a matrixed examination of the financing variables and how these variables correlate with impact, as well as legal, regulatory, or operational challenges.

Michael Ciarametaro, MBA, Vice President, of NPC said, “It is imperative for patient access, developer innovation and payer success that possible solutions go through a vetting process to determine their impact, including cost saving, administrative burden, and whether they impede the availability of these new therapies.”

“NPC has long been a strong partner in the FoCUS Project,” said Mark Trusheim, NEWDIGS’s Strategic Director. “This research will objectively analyze multiple Medicaid Best Price concepts to help determine the solution that has little or no impact on the Medicaid program.” 

Since 2016, FoCUS has worked to develop and deliver an objective understanding of the challenges and financial impacts posed by new cell and gene therapies for all stakeholders in the healthcare ecosystem. This new research with NPC builds on the FoCUS work and will help elucidate what is contemplated by stakeholders, and compartmentalize the effects of solutions to lay the groundwork for future, successful implementation that serves the twin goals of ensuring Medicaid’s mission and providing timely patient access.

The FoCUS / NPC team anticipates producing findings that will be publishable in a peer reviewed journal.