Get the most value and best outcomes from CGT

Gene therapy works by repairing or replacing faulty genes to cure or help the body fight disease. Similarly, cell therapy involves the transplantation of healthy cells to replace or repair damaged ones, offering another avenue for treating various conditions. The U.S. Food and Drug Administration (FDA) has approved cell and gene therapy (CGT) products for several conditions, including cancer, spinal muscular atrophy, hemophilia and sickle cell disease.¹ CGTs stand apart from traditional drug treatments due to their complex administration methods and costs reaching up to $4.25 million for a single dose gene therapy.² These therapies present special challenges that must be resolved to make them readily accessible and affordable for patients who need them.³

Several CGTs in development could significantly impact health care costs.⁴ Although some require multiple doses, many hold the promise to cure intractable diseases with just a single dose. Managing CGT costs requires innovative strategies such as prior authorization, risk carve-outs, value-based contracting and installment payment plans—helping ensure patients can access these life-changing therapies.⁵