CMS details program to use outcomes-based agreements to pay for sickle cell gene therapies
US Medicaid programs will test a payment model that will reimburse multimillion-dollar gene therapies based on patient outcomes, in an early step toward efforts to finance high-science, high-cost treatments.
Starting next year, the Centers for Medicare and Medicaid Services (CMS) will test outcomes-based agreements to pay for the sickle cell gene therapies. Two of the one-time gene therapies, Vertex and CRISPR Therapeutics’ Casgevy and bluebird bio’s Lyfgenia, were approved by the FDA in December with list prices of $2.2 million and $3.1 million, respectively.
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