Paying for Cures Tools and templates
Do you need guidance in developing your strategy for the cell and gene therapy (CGT) market? Are you looking for data to assess how CGTs will impact you and your organization? We offer a number of resources to support your work.
Pipeline analysis
NEWDIGS FoCUS maintains a gene and cell therapy (CGT) pipeline by analyzing clinical trials currently registered for the treatment of specific indications. The pipeline analysis was most recently updated through December 31, 2022.
FoCUS has delivered this analysis as an individual Indication workbook and as a pipeline impact worksheet. You may download the Excel documents, then customize the inputs to assess the pipeline’s impact according to scenarios you define. Note that terms and conditions apply with the use of the workbooks.
Individual Indication workbook
The Individual Indication workbook enables you to select an indication for treatment and complete an assessment of the number of individuals estimated to be eligible for treatment, the potential budget impact of treating eligible individuals, and the likelihood that an organization (based on size and payer type) will encounter treatment eligible patients. You may download the workbook and use it in accordance with the defined terms and conditions.
Pipeline impact
NEWDIGS FoCUS built a pipeline analysis of cell and gene therapies (CGTs) to determine the scale of the financing challenge of CGTs in the US. To forecast the number of product launches, the team estimated the time products would take to progress through each level of trials, and estimated probabilities of success (defined as the probability that a product, upon completing one level in the trials, will initiate a trial at the next level) of each trials program. The model uses a Markov Chain Monte Carlo process with results typically based on one million iterations. Projections are further detailed into a pipeline by payer type. You may download the workbook and use it in accordance with the defined terms and conditions.
Developer tools and templates
FoCUS has proposed new and innovative financing models for CGTs to address patient access and financial stability for all stakeholders. Adopting these models and achieving patient access requires awareness, sensitivity, and prioritization of the issues of all stakeholders in gene and cell therapy treatment.
From the developer’s perspective, the goal is to optimize access and outcomes. This may take the form of educating others on the new market challenges with CGT. Or it may require offering insights on the value of adopting an innovative finance model. We offer a number of resources for your work on these topics.
Financial Solutions Education
To design innovative financial solutions that can be used to improve patient access, developers must understand key concepts regarding CGT financing models. You may use our slides as background information for internal presentations or external discussions on the overall cell and gene therapy pipeline, innovative finance solutions and the differences between chronic and durable therapies.
Pipeline education (PDF)
These slides can inform you of the current cell and gene therapy pipeline and its impact by payer type.
Implementing Precision Financing Solutions (PDF)
To assist payers in selecting Precision Financing Solutions, these slides cross-reference the Precision Financing Solutions with implementation challenges.
Payer tools and templates
FoCUS has proposed new and innovative financing models for gene and cell therapies (CGTs) to address patient access and financial stability for all stakeholders. Adopting these models and achieving patient access requires awareness, sensitivity, and prioritization of the issues of all stakeholders for CGT treatments.
From a payer’s perspective, the goal is to maintain financial stability while allowing access to high-cost CGTs. Actions may include educating others on the financial challenges and innovative financing solutions associated with CGT. Or payers may assess their resources to adopt an innovative finance model. The sections below offer resources for your work.
Pipeline education (PDF)
These slides can inform you of the current cell and gene therapy pipeline and its impact by payer type.
Implementing Precision Financing Solutions (PDF)
To assist payers in selecting Precision Financing Solutions, these slides cross-reference the Precision Financing Solutions with implementation challenges.
Strategic planning for cell and gene therapy
Payers’ line of business and size will strongly influence how CGTs affect their budget. Use the Pipeline Analysis Model workbooks to determine your next steps to prepare for the pipeline of CGTs. These resources provide guidance for defining components of a payer strategy, identifying partners in that strategy, and applying for a Medicaid plan amendment for CGT.
Questionnaire for CGT service supplier evaluation (PDF)
Create your own vendor request for services proposal based on questions in this evaluation.
Tools for implementation of Precision Financing Solutions within Medicaid plans (PDF)
Use this document to think through development of a State Plan Amendment for value-based purchasing contracts.
Patient tools and templates
FoCUS has proposed new and innovative financing models for gene and cell therapies (CGTs) to address patient access and financial stability for all stakeholders. Adopting these models and achieving patient access requires awareness, sensitivity, and prioritization of the issues of all stakeholders in CGT treatments.
If a patient changes their treatment from a chronic to a durable therapy, this shift impacts patient engagement, most notably with the introduction of performance-based agreements. Patients, caregivers, and patient advocacy groups would benefit from understanding how CGT impacts patients and engaging in developing criteria and conditions to minimize patient burden for treatment administration and performance contract execution.
Pipeline analysis
NEWDIGS FoCUS maintains a gene and cell therapy (CGT) pipeline by analyzing clinical trials currently registered for the treatment of specific indications. The pipeline analysis was most recently updated through December 31, 2022.
FoCUS has delivered this analysis as an individual Indication workbook and as a pipeline impact worksheet. You may download the Excel documents, then customize the inputs to assess the pipeline’s impact according to scenarios you define. Note that terms and conditions apply with the use of the workbooks.
Individual Indication workbook
The Individual Indication workbook enables you to select an indication for treatment and complete an assessment of the number of individuals estimated to be eligible for treatment, the potential budget impact of treating eligible individuals, and the likelihood that an organization (based on size and payer type) will encounter treatment eligible patients. You may download the workbook and use it in accordance with the defined terms and conditions.
Pipeline impact
NEWDIGS FoCUS built a pipeline analysis of cell and gene therapies (CGTs) to determine the scale of the financing challenge of CGTs in the US. To forecast the number of product launches, the team estimated the time products would take to progress through each level of trials, and estimated probabilities of success (defined as the probability that a product, upon completing one level in the trials, will initiate a trial at the next level) of each trials program. The model uses a Markov Chain Monte Carlo process with results typically based on one million iterations. Projections are further detailed into a pipeline by payer type. You may download the workbook and use it in accordance with the defined terms and conditions.
Developer tools and templates
FoCUS has proposed new and innovative financing models for CGTs to address patient access and financial stability for all stakeholders. Adopting these models and achieving patient access requires awareness, sensitivity, and prioritization of the issues of all stakeholders in gene and cell therapy treatment.
From the developer’s perspective, the goal is to optimize access and outcomes. This may take the form of educating others on the new market challenges with CGT. Or it may require offering insights on the value of adopting an innovative finance model. We offer a number of resources for your work on these topics.
Financial Solutions Education
To design innovative financial solutions that can be used to improve patient access, developers must understand key concepts regarding CGT financing models. You may use our slides as background information for internal presentations or external discussions on the overall cell and gene therapy pipeline, innovative finance solutions and the differences between chronic and durable therapies.
Pipeline education (PDF)
These slides can inform you of the current cell and gene therapy pipeline and its impact by payer type.
Implementing Precision Financing Solutions (PDF)
To assist payers in selecting Precision Financing Solutions, these slides cross-reference the Precision Financing Solutions with implementation challenges.
Payer tools and templates
FoCUS has proposed new and innovative financing models for gene and cell therapies (CGTs) to address patient access and financial stability for all stakeholders. Adopting these models and achieving patient access requires awareness, sensitivity, and prioritization of the issues of all stakeholders for CGT treatments.
From a payer’s perspective, the goal is to maintain financial stability while allowing access to high-cost CGTs. Actions may include educating others on the financial challenges and innovative financing solutions associated with CGT. Or payers may assess their resources to adopt an innovative finance model. The sections below offer resources for your work.
Pipeline education (PDF)
These slides can inform you of the current cell and gene therapy pipeline and its impact by payer type.
Implementing Precision Financing Solutions (PDF)
To assist payers in selecting Precision Financing Solutions, these slides cross-reference the Precision Financing Solutions with implementation challenges.
Strategic planning for cell and gene therapy
Payers’ line of business and size will strongly influence how CGTs affect their budget. Use the Pipeline Analysis Model workbooks to determine your next steps to prepare for the pipeline of CGTs. These resources provide guidance for defining components of a payer strategy, identifying partners in that strategy, and applying for a Medicaid plan amendment for CGT.
Questionnaire for CGT service supplier evaluation (PDF)
Create your own vendor request for services proposal based on questions in this evaluation.
Tools for implementation of Precision Financing Solutions within Medicaid plans (PDF)
Use this document to think through development of a State Plan Amendment for value-based purchasing contracts.
Patient tools and templates
FoCUS has proposed new and innovative financing models for gene and cell therapies (CGTs) to address patient access and financial stability for all stakeholders. Adopting these models and achieving patient access requires awareness, sensitivity, and prioritization of the issues of all stakeholders in CGT treatments.
If a patient changes their treatment from a chronic to a durable therapy, this shift impacts patient engagement, most notably with the introduction of performance-based agreements. Patients, caregivers, and patient advocacy groups would benefit from understanding how CGT impacts patients and engaging in developing criteria and conditions to minimize patient burden for treatment administration and performance contract execution.