Spreading payments over time for durable or curative therapies can provide a better alignment between benefits and costs, but creates challenges when patients switch insurance coverage during the contract term. … Read More
Orphan Reinsurer Benefit Managers (ORBMs)
An Orphan Reinsurer Benefit Manager (ORBM) could address the financial challenges (payment timing, therapeutic performance risk, actuarial risk), created by durable/potentially curable gene and cell therapies especially for smaller insurers … Read More
ISPOR
Jane Barlow for FoCUS
Precision Financing strategies explored in FoCUS Design Lab
Healthcare innovation stakeholders co-develop solutions to make curative therapies accessible to patients, propose new pilot project CAMBRIDGE, MASSACHUSETTS—The NEWDrug Development ParadIGmS (NEWDIGS) initiative at the MIT Center for Biomedical Innovation (CBI) hosted … Read More
Impact of Actuarial Risk on Health Plans
The uncertain number of patients likely to be treated with an expensive novel therapy (actuarial risk) could represent a major financial issue for some payers. In this brief, we will … Read More
FoCUS Project: Recent International Event Highlights (April 2018)
NEWDIGS FoCUS project leaders have appeared in three recent meetings to share emerging perspectives on financing potentially durable but expensive new therapies. Casey Quinn and R. John Glasspool speak at … Read More
Designing Precision Financing for Cures
Designing Precision Financing for cures can be informed by a framework that tailors solutions to the three financing challenges of actuarial risk, performance risk and payment timing based on the … Read More
The heterogeneity of health care payers suggests that durable therapies need precision financing targeted to each payer segment
FoCUS participants have identified four payer segments for precision financing: self-insured employers and related organizations; health insurance plans and managed care organizations; Medicare; and Medicaid. Download FoCUS Research Brief_2018F202-014Share the … Read More
Payers Open to Innovative Financing Mechanisms for High Cost Gene Therapies
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 … Read More