Jane F. Barlow, Matt W. Courtney, and Mark Trusheim of the FoCUS Project contributed the article to PharmExec.com, published January 9, 2020. The reimbursement of emerging durable and potentially curative … Read More
Payer Perspectives on Reimbursement of One-Time High-Cost Durable Therapies
Pharmaceutical Executive, January 9, 2020Matt W. Courtney, Jane F. Barlow, Mark Trusheim The reimbursement of emerging durable and potentially curative cell and gene therapies challenge U.S. payers due to their … Read More
Precision Financing challenges for solid tumor adoptive T-cell therapies
Durable gene and cell therapies represent a unique challenge to the US healthcare insurer/payer landscape, given the one-time treatment and associated high upfront cost but potentially durable outcomes. Previous research … Read More
FoCUS Monthly Recap: December 2019
Year in FoCUS 7 research briefs, 4 white papers, and 2 peer-reviewed articles published; 40+ speaking engagements and conference appearances, 20+ appearances in media, 450+ attendees to Design Labs and … Read More
Making Cell and Gene Therapies Financially Accessible and Sustainable
CAMBRIDGE, Massachusetts, December 5—The Financing and Reimbursement of Cures in the US Consortium (FoCUS) launched the Paying for Cures Toolkit today. The free online resource helps payers, patient advocates, drug … Read More
Tools for Implementation of Precision Financing Solutions Within Medicaid Plans
Implementation of precision financing solutions is a challenge for state Medicaid payers given the complexity of the environment. This white paper provides example templates to support state Medicaid plans, manufacturers, and … Read More
Payer Perspectives on Financing and Reimbursement of One-time High-cost Durable Treatments
An online 15-question survey was conducted with clinical and financial health plan leaders from US payers between September 2018 and April 2019. The survey was focused on assessing payer perspectives … Read More
Tracking Medicaid Coverage of Durable Cell and Gene Therapies
Durable cell and gene therapies represent a unique challenge to the US healthcare insurer/payer landscape, given the one-time treatment and associated high upfront cost but potentially durable outcomes. This study … Read More
The Role of Stop-Loss Insurance and Reinsurance in Managing Performance-Based Agreements
Over the last decade, rising healthcare costs and the availability of expensive new treatment options has led to a substantial increase in the number of patients with large insurance claims. … Read More
State Insurance Regulations Regarding Benefit Design (Deductible and Co-Pay Waivers)
FoCUS has identified an issue that may be a barrier to timely patient access to durable therapies. The advent of expensive, one-time durable therapies will require changes in private payer … Read More