Medicaid programs in the United States will experiment with a payment model that will reimburse high-cost gene therapies based on patient outcomes, marking an early step in efforts to fund treatments with advanced science at high prices.
Beginning next year, the Centers for Medicare and Medicaid Services (CMS) will test outcomes-based agreements for the payment of sickle cell gene therapies. Two one-time gene therapies, Vertex and CRISPR Therapeutics’ Casgevy and bluebird bio’s Lyfgenia, received FDA approval in December with list prices of $2.2 million and $3.1 million, respectively.
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