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Curative Gene Therapy Coverage May Need Government-Funded Risk Pools

 
• By Cathy Kelly

Former US FDA commissioner Scott Gottlieb makes a case for regional or national risk pools to ensure pediatric patients get timely access to gene therapy like the upcoming treatments for sickle cell disease.

The little girl in the water park swimming underwater and smiling - Image
Disparity in access between Medicaid and private plans for high-cost therapies could be particularly problematic, Gottlieb says. • Source: Shutterstock

Implementation of government-supported risk pools across US payers on a regional or state basis should be considered as a solution to paying for specific types of gene therapy, former FDA Commissioner Scott Gottlieb suggested at a meeting sponsored by the Duke Margolis Center for Health Policy on 11 September.

Many policy discussions about paying for curative therapies have focused on annuity models and value-based contracts, he noted. But “do we need to perhaps consider mechanisms where you just pool...

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