Reality Check? Medicaid Costs From Cell, Gene Therapies Projected At (Just) $1Bn-$4Bn By 2030
Based on the current pipeline of durable therapies, MIT research indicates ‘it’s not a big lift to cover the children and the adults in Medicaid for these products,’ Mark Trusheim says.
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Only about one-quarter of the 40 gene therapies projected to launch by the end of 2025 would have potential US patient populations of more than 50,000. But a handful of treatments could target millions of individuals.
Former senior advisor to President Trump warns that failure to reform drug pricing practices has seriously handicapped prospects for reimbursing cell and gene therapy under existing US payer programs.
With price controls in Medicare looming nine years after approval, launch strategies such as ‘bridge’ programs that build initial volume with free drug may have to be adjusted.