FoCUS hosted a virtual Paying for Cures one-day conference on August 18 examining the challenges public and private payers face when considering new cell and gene therapies.

The latest in a series of public events to share the lessons and tools emerging from the Financing and Reimbursement of Cures in the US (FoCUS) Project assembled a cross-sector representation of people at the cutting edge of enabling access to innovative cell and gene therapies. Attendees got first-person, real-world wisdom about practical approaches to making new treatments accessible and sustainable. 

Workshop highlights: 

• Mark Hansan (President and CEO, CareMetx) provided an overview of the FoCUS project, explaining how the cross-sector consortium has defined and gone about solving the financing problems presented by new cell and gene therapies. He noted the work could become a platform for global change, stating “the therapies in the pipeline will impact millions of people who’ve waited their entire lives for them…we need to create generational change in how we think about financing them.”
• Colin Young (Director, Drug Development Pipeline Research, NEWDIGS FoCUS Project) gave an overview of the pipeline of therapies and projected their availability for a range of indications. His analysis helped participants understand their own actuarial implications, potential risks, and benefits.
• John Glasspool (CEO and President, Anthos Therapeutics Inc) moderated a panel on Precision Financing Solutions from a Medicaid perspective. The panel included Terry Cothran (Senior Pharmacy Director, Oklahoma Health Care Authority), Sabrina Gibson (Vice President and the Chief Medicaid Actuary, WellCare), Coy Stout (Vice President, US Commercial Access & Reimbursement Solutions, Gilead Sciences), and Laura Okpala (Director, Reimbursement Policy, Gilead Sciences). The panelists shared their experience with innovative solutions that balance patient-focused collaboration with business imperatives, with Stout calling for “openness and engagement by all stakeholders to achieve mutual benefit and progress” and a focus on shared objectives.
• Jane Barlow (Senior Advisor, NEWDIGS FoCUS Project) moderated the panel on the commercial payer perspectives on Precision Financing Solutions. The panel included Cindy Pigg (Vice President Managed Care, Cardinal Health), Karen Geary (Vice President, Strategy and Innovation, MedImpact Healthcare Systems, Inc.), Desiree Otenti (Senior Director, Medical Policy and Program Implementation, Blue Cross Blue Shield of Massachusetts), and Crystal Kauder (Chief Pricing Actuary, US Health, PartnerRe). Themes of the discussion included how organizations could manage and spread risk, and the help they need to enable coverage. 

To see the detailed agenda and learn more about the Paying for Cures resources from the FoCUS Program, please visit https://www.payingforcures.org/august2020/