Radar on Drug Benefits

Payers Worry About High Costs, Low Evidence for Gene Therapies

  • Jun 09

    Jun 09, 2022

    So far, the FDA has approved eight cell and gene therapies, but the agency is expected to approve several more medications in those classes in the next few years. That has caused concern for payers because such medications have high costs and limited clinical evidence, according to speakers who participated in an Avalere Health webinar on May 25.

    As such, the federal government, PBMs, health insurers and other payers are testing innovative ways to reimburse hospitals, providers and pharmaceutical companies for administering cell and gene therapies.

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    • Tim Casey

    Tim has been a reporter and editor for newspapers, websites and magazines for more than 20 years, including 10 years covering health care business topics. He has a deep knowledge of the managed care industry and pharmacy benefit management. He also has experience covering medical conferences and clinical and legislative health care issues. In 2014, the Society for Advancing Business Editing and Writing selected Tim as one of 15 journalists to participate in a national symposium on the Affordable Care Act. Tim has a B.A. in Psychology from the University of Notre Dame and an M.B.A. from Georgetown University.

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