The Center for Medicare and Medicaid Innovation’s planned Medicare payment experiment for gene therapy for sickle cell disease may not have a big impact until at least 2026 because Medicaid managed care organizations will not be included in the model until then.
Key Takeaways
-
Medicaid Managed Care participation in model would not be required until January 2026, which means the majority of Medicaid enrollees may not see the benefit of the model until then.
-
Questions persist about whether the timing of the model could delay access to the therapies for Medicaid enrollees, but marketers are moving ahead with their own negotiations
Under the demonstration, the Centers for Medicare and Medicaid Services would represent a group of states in negotiating outcomes-based agreements for bluebird bio’s Lyfgenia and Vertex’s Casgevy that tie Medicaid payment to health outcomes over a certain period of time
Read the full article – start your free trial today!
Join thousands of industry professionals who rely on Pink Sheet for daily insights
- Start your 7-day free trial
- Explore trusted news, analysis, and insights
- Access comprehensive global coverage
- Enjoy instant access – no credit card required
Already a subscriber?
