Medicare CAR-T Payment Policy Walks Line Between Innovation and Cost Concerns
CMS proposes new DRG with higher average payment rate for CAR-T therapy but signals new technology add-on payments will no longer be awarded to supplement reimbursement.
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Products from Bristol-Myers Squibb, Gilead and J&J might be eligible for supplemental reimbursement under hospital payment proposed rule that could help promote uptake.
Idecabtagene vicleucel for fifth-line multiple myeloma lags GSK’s BCMA-targeting ADC Blenrep, but it is months ahead of J&J/Legend’s CAR-T. Abecma is BMS’s second CAR-T approval this year.
Speculation is growing that the Institute for Clinical and Economic Review or something like it could become the US version of the government-sponsored health tecnology assessment bodies in Europe.