CMS to in­crease re­im­burse­ment for new sick­le cell gene ther­a­pies

The Cen­ters for Medicare and Med­ic­aid Ser­vices (CMS) said Wednes­day that it will in­crease re­im­burse­ments for two new­ly ap­proved sick­le cell gene ther­a­pies that could po­ten­tial­ly re­verse the de­bil­i­tat­ing ef­fects of the dis­ease.

CMS typ­i­cal­ly re­im­burs­es 65% of the cost of a new tech­nol­o­gy, but will in­crease that to 75% for Ver­tex Phar­ma­ceu­ti­cals’ and CRISPR Ther­a­peu­tics’ Cas­gevy, as well as for blue­bird bio’s Lyf­ge­nia, ac­cord­ing to a pro­posed rule. The change will take ef­fect in the US gov­ern­ment’s 2025 fis­cal year and con­clude at the end of the two- to three-year so-called “new­ness” pe­ri­od.

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