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Business & Regulation Advanced Medicine

Cell and Gene Pricing: How Can Manufacturers Get it Right?

Ana Stojanovska, Vice President of Commercial Consulting at Xcenda, has close to two decades of experience in reimbursement and health policy. Now she assists a number of biopharmaceutical companies with their understanding of the coverage and reimbursement landscape. Here, Ana shares her approach to, and experience of, working with manufacturers on their payment models.

Are manufacturers open to alternative payment and reimbursement models?

Yes! There is so much scrutiny around drug pricing that we see manufacturers proactively approaching payers, making proposals and being part of the solution. While there are numerous challenges with designing and implementing alternative payment models, many of the newly launched gene therapies are taking the challenges to heart and showing not just willingness, but often leadership in engaging in some more innovative payment concepts. For example, the gene therapies that have recently launched in the US have all coupled their launch announcements with some sort of outcomes-based payment messages. These have varied in scope and detail, but generally have included arrangements with both public and private payers that tie reimbursement for the therapy to achieving certain pre-defined outcomes within a specified timeframe.

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  1. CMS, “Proposed decision memo for chimeric antigen receptor (CAR) T-cell therapy for cancers” (2019). Available at: https://go.cms.gov/2TNoJZe.

About the Author

Ana Stojanovska

Vice President of Commercial Consulting at Xcenda

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