Payers Open to Innovative Financing Mechanisms for High Cost Gene Therapies

Eric NormanFoCUS, Research Briefs


In a broad survey, payers favor performance based milestone contracts and risk pools strategies to absorb the surge of high cost gene therapy products expected to enter the market over the next three to five years. The current financing model employing premium increases, higher patient out-of-pocket costs, reinsurance and stop-loss policies is viewed as unsustainable, although the critical issues vary by payer type. Medicaid is further constrained by regulatory requirements and has less flexibility than other payer segments to actively manage these new costs.

Download FoCUS Research Brief_2017F212-012

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