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The Impact of Cell and Gene Therapy on the Payer System
Session Chair(s)
Marianne Hamilton Lopez, PhD, MPA
Research Director, Value-Based Payment Reform
Duke-Margolis Center For Health Policy, United States
New therapeutic approaches are emerging, including gene therapies, cell therapies, gene editing technologies, and other tissue engineering therapies, that hold the promise of producing long-term and durable responses to serious conditions. Despite their great potential, a key question is how these therapies will impact the payer and reimbursement system due to their potentially high up-front costs within the traditional fee-for-service payment model. This session will focus on the need for a combined stakeholder approach to understand the pipeline of future therapies, to achieve partnerships across sectors, to explore how gene and cell therapies might impact the current payer and reimbursement system, and to address both access and affordability. The session will also present a paper, developed by the Duke-Margolis Value-Based Payment Consortium that considers potential benefits and challenges of proposed value-based payment approaches that have the potential to align payers, manufacturers, and providers towards greater value.
Learning Objective : Discuss cell and gene therapies and the differences between therapeutics; Examine how these therapies impact models for reimbursement and payment within the current fee-for-service model; Discuss ongoing efforts to explore new financial mechanisms and value-based payment models.
Speaker(s)
Cell and Gene Therapy Development and the Impact on the Payer System
Dan Tierno, MA, MBA
Daiichi Sankyo, Inc, United States
Associate Director, Project and Portfolio Management
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