Tracking Medicaid Coverage of Durable Cell and Gene Therapies

Joseph KnoxFoCUS, Research Briefs

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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 focuses on Medicaid coverage policies by state for Luxturna (for inherited form of blindness), Kymriah (for pediatric blood cancer acute lymphatic leukemia (ALL) and adult blood cancer diffuse large B-cell lymphoma (DLBCL)) and Yescarta (for DLBCL), which were all approved and launched in 2017.

Download FoCUS Research Brief 2019F209v043

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