How can self-insured employers prepare for the portfolio impact of highcost gene therapies coming to market?

Eric NormanFoCUS, Research Briefs

Self-insured employers (SIEs) currently rely on traditional stop-loss insurance to protect against unexpected high-cost claims, including those for cell and gene therapies. Given that current approvals are in rare diseases, … Read More

Emerging market solutions for financing and reimbursement of durable cell and gene therapies

Eric NormanFoCUS, Whitepapers

The FoCUS project was launched in 2016 with the aim of developing precision financing solutions that address the challenges and financial impact created by durable cell and gene therapies entering … Read More

Payer perspectives on outcomes tracking for value-based payment arrangements (VBPs)

Eric NormanFoCUS, Research Briefs

Share the researchWith the new CMS rule changing Medicaid Best Price reporting to encourage VBPs, many options are available for which healthcare system players will collect, protect and adjudicate the … Read More

Updated projection of US durable cell and gene therapies product-indication approvals based on December 2019 development pipeline

Eric NormanFoCUS, Research Briefs

Ongoing pipeline modeling by the MIT NEWDIGS FoCUS team projects 10X growth from July 2020 levels, but with large uncertainties. Download FoCUS Research Brief 2020F207v51Share the research

Payer Perspectives on Financing and Reimbursement of One-time High-cost Durable Treatments

Eric NormanFoCUS, Whitepapers

An online 15-question survey was conducted with clinical and financial health plan leaders from US payers between September 2018 and April 2019. The survey was focused on assessing payer perspectives … Read More

Tracking Medicaid Coverage of Durable Cell and Gene Therapies

Eric NormanFoCUS, Research Briefs

Durable cell and gene therapies represent a unique challenge to the US healthcare insurer/payer landscape, given the one-time treatment and associated high upfront cost but potentially durable outcomes. This study … Read More

State Insurance Regulations Regarding Benefit Design (Deductible and Co-Pay Waivers)

Eric NormanFoCUS, Research Briefs

FoCUS has identified an issue that may be a barrier to timely patient access to durable therapies. The advent of expensive, one-time durable therapies will require changes in private payer … Read More

Payer Perspectives Survey

Eric NormanFoCUS, Research Briefs

A survey of 77 payers representing over 280 million lives, completed in April 2019, explored perspectives concerning financing challenges and management strategies associated with durable cell and gene therapies. Download … Read More

Pediatric Gene Therapy Launches

Eric NormanFoCUS, Research Briefs

Gene therapy cures for hereditary genetic conditions are likely to reach the United States market in the coming decades. Several disease areas with potential cures are orphan conditions, which affect … Read More