This brief offers a checklist of key steps that different stakeholders should consider to ensure patients have access to innovative treatments. These therapies present unique challenges for different stakeholders and … Read More
Implementation Brief: Key terms for payment innovation
This brief provides definitions of key terms that are often used in discussions about designing and implementing innovative payment solutions. It offers an overview of solution models, types of risk, … Read More
Managing the Challenges of Paying for Gene Therapy: Strategies for Market Action and Policy Reform
Gene therapies delivered through a single administration have revolutionized treatment possibilities for many patients living with serious or fatal conditions such as spinal muscular atrophy, hemophilia, and sickle cell disease. … Read More
Emerging market solutions for financing and reimbursement of gene therapies for sickle cell disease: Why do payment innovation?
The FDA has approved two cell and gene therapies for sickle cell disease, marking a significant development for the largest population condition to date. However, the high treatment costs, … Read More
Payer and developer perspectives on alternative payment models
Expert Review of Pharmacoeconomics & Outcomes Research, Volume 24, 2024 – Issue 2Moradian, R., Meshesha, T., Trusheim, M., & Barlow, J. F. The paper reports the results of a survey … Read More
How can self-insured employers prepare for the portfolio impact of highcost gene therapies coming to market?
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
Precision Reimbursement for Precision Medicine: Using Real-World Evidence to Evolve From Trial-and-Project to Track-and-Pay to Learn-and-Predict
Basic scientists and drug developers are accelerating innovations toward the goal of precision medicine. Regulators create pathways for timely patient access to precision medicines, including individualized therapies. Healthcare payors acknowledge … Read More
Emerging market solutions for financing and reimbursement of durable cell and gene therapies
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)
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
The resource navigation challenges for patients and caregivers
Share the researchWhile the problem of finding system-wide, implementable precision financing models for curative and durable therapies involves all stakeholders, patients and caregivers are directly affected by many different elements … Read More