CMS Wants To Help With Medicaid Outcomes-Based Reimbursement For Cell And Gene Therapy
Center for Medicare and Medicaid Innovation (CMMI) deputy director Ellen Lukens talked about the goals and challenges of a new voluntary program the agency will test with state Medicaid programs.
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Multiple gene therapies have been approved in the last couple of years, but market access and reimbursement for gene therapies remain challenging – a key theme of the Cell & Gene Meeting on the Mesa.
But CMMI does not yet have a launch date for the proposed Medicare demonstration on drugs cleared through FDA’s accelerated approval pathway and the demonstration allowing Part D plans to offer certain high-value generics with a $2 beneficiary copay.
The demonstration project planned by the US Centers for Medicare and Medicaid Services is in keeping with past agency efforts to promote value-based contracts for cell and gene therapy.