Who’s Paying for Million-Dollar Gene Therapies?
By Karen Fischer,
BioSpace
| 06. 12. 2024
When Orchard Therapeutics announced the $4.25 million price tag in March for its newly approved rare disease gene therapy Lenmeldy, it became the most expensive on the market. But since 2019, the FDA has approved five others that cost more than $2 million. Some insurers, even when legally required, are not having it when it comes to paying out the cost of a treatment.
A November 2023 ProPublica investigation found that insurance provider Priority Health quietly nixed coverage of gene therapies as a cancer treatment, even though under Michigan state law the payer was required to cover clinically effective cancer drugs. The gene therapy in question, CAR-T, was the last hope for patient Forrest VanPatten to recover from an aggressive case of lymphoma. According to ProPublica, his CAR-T treatment was estimated to cost $475,000. VanPatten died while waiting for the results of his third request for coverage.
Globally, many healthcare systems are choosing not to cover gene therapies at all. Even though every health regulatory body reviews the same scientific and trial information, Canada and countries across Europe have completely different...
Related Articles
Reproductive rights have been a flashpoint in national politics for decades, with the stakes surging after the Supreme Court shredded the right to an abortion. In the current presidential campaign, the battle over abortion has swelled and morphed to encompass in vitro fertilization (IVF), which has now moved rapidly from widely accepted to partisan hot button.
This dramatic shift was highlighted by the February decision of the Alabama Supreme Court that granted personhood rights to frozen IVF embryos, signaling that...
By Sara Moretto, The Varsity | 09.22.2024
It was 2020. I was wrapping up grade nine science with a solid 60 per cent, hoping that if anyone saw my failed tests in the recycling bin, it would contribute to an air of mystery about me. This reason...
By Don Sapatkin, Managed Healthcare Executive | 09.20.2024
Gene therapy comes with the expectation that it will “cure” an expanding number of genetic disorders. If you’ve never wondered – and even if you have -- what that word actually means, four Dutch researchers have a surprise in store...
By Heidi Ledford, Nature | 09.17.2024
For most of her life, Genesis Jones’s daily routine revolved around her illness, the painful blood disorder known as sickle-cell disease. Each time she left the house, she ran through a mental checklist: did she have her pain medications...