Precision Financing Solutions
The NEWDIGS FoCUS consortium, which includes payers, providers, patient advocacy organizations, pharmaceutical developers, academics, and others, has been working collaboratively since 2016 to address the need for new, innovative financing and reimbursement models for transformative cell and gene therapies (CGTs) in the US in order to ensure patient access and sustainability for all stakeholders.
FoCUS does not address how to value these therapies or set their prices. Payers and other organizations have methodologies to do so. Rather, FoCUS seeks to create Precision Financing Solutions for durable, potentially curative therapies with large, upfront costs whose benefits accrue over time.
FoCUS participants have identified over 20 individual financing tools, finding no single tool with the ability to meet all needs for every stakeholder. The participants then combined the tools into three sets that could address significant financial challenges for the stakeholders. The multi-stakeholder FoCUS participants created sets for payment timing risks, performance risks, and actuarial risks in FoCUS “Design Lab” workshops held every six months, with sub-teams working between Design Labs. Each Precision Financing Solution identified addresses key challenges associated with CGTs, but no one solution addressed all challenges.
Payers should select a financial tool based upon their assessment of the specific therapy and their organizational needs.
The highest-potential Precision Financing Solutions identified by FoCUS participants are listed below. By clicking on each solution, you can find a concise description and links to additional resources.