Cell/Gene Therapy Pay Models Face Reporting, Policy Barriers

Emerging cell and gene therapy oncology treatments are well suited to value-based payment arrangements, but new contracting models must be able to contend with a complex regulatory and financial environment, experts say.

A new generation of oncology treatments that can cure specific cancers offer a potential breakthrough. Patients who would have had to struggle through chemotherapy and still faced long odds now have the chance to make a significant recovery with one or two rounds of treatment. However, these treatments are extraordinarily expensive — some can cost tens of thousands of dollars for a single course of treatment.

“Because they’re typically only administered once, that single administration has a high associated cost that’s not spread out over time,” explained Jay Jackson, a principal at Avalere Health, during a June 29 podcast.

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