Stakeholder views on Precision Financing

The NEWDIGS FoCUS consortium (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 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 identified over 20 individual financing tools, no single one of which could meet all needs for every stakeholder. The participants then combined the tools into sets that formed Financial System Solutions (FSS), which in combination could address significant financial challenges for the stakeholders. The multi-stakeholder FoCUS participants created these customizable Financial System Solutions in FoCUS “Design Lab” workshops held every six months with sub-teams working between Design Labs.

The critical precision financing dimensions to be addressed were payment timing, performance, and actuarial risk. Each FoCUS precision financing solutions identified addressed key challenges associated with cell and gene therapies but no one solution addressed them all.

The financial tool selected for payer use will be based upon a payer’s 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 of each and links to additional resources.

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