Could reinsurance allay health insurers' fear about high cell and gene therapy costs?
With the prospect of many cell and gene therapies coming to market in the medium term, often with record breaking list prices and with the potential to be one time cures, there is a vigorous debate about the best way to pay for these advanced medicines. Health insurance companies are in fear of the financial impact that unplanned catastrophic costs associated with cell and gene therapy products could have. For some, reinsurance offers, at least part, a solution. But is the reinsurance industry geared up for this unique challenge? Who pays the premium? Is reinsurance a sustainable model suitable for all health payers? What can pharma companies do to help and ensure optimum market access for their cell and gene therapy portfolios?
Reinsurance is just part of the debate on a solution for the sustainable funding of high-cost cell and gene therapies that is neither clear nor straightforward. That is why in, Financing High-Cost Therapies through Reinsurance we interviewed financing and market access experts to help you understand the challenges and benefits of reinsurance and the positive steps industry can take now to influence the cell and gene therapy funding agenda.
Experts explore key reinsurance questions
What our experts say…
"Innovators do have a fear that payers will exclude high-cost cell and gene therapy from coverage. I haven't seen an indication, at least in the therapies that have been approved so far, that that's going to be the case. In part, it's because, no payer wants to be on the front page of the paper for being the one not to cover."
Jane F Barlow
"Reinsurance is not a single solution, but it will help some smaller payers and self-insured employers absorb a lightning strike, one-off or limited use of high cost therapies in their covered population in the future."
VP, Biotech Company
"Payers need to get a good actuary, but more than that, they need to have robust model assumptions. Companies and others need to really work closely with the payer and understand their needs."
Steve Bradshaw
"One of the potential future benefits of reinsurance is that it could spur innovation. Pharmaceutical manufacturers are paid in full, and right away. That would create a more attractive market place for other manufacturers to dive in. They would see that there is an early opportunity, early returns. Whereas if you have the annuity model or an outcomes mode, then your reimbursement isn't as concrete. You might be getting paid the same amount for a patient, but it takes longer, or you might not get paid at all if the drug fails. Reinsurance offers benefit, especially to industry, and you'd probably see more investment and a bigger push."
Jeremy Schafer
What to expect
About the Experts contributors
All experts were screened for participation on the basis that they had the following:
Expert Contributors to this report
Why Choose FirstWord FutureViews?
FirstWord FutureViews reports analyze in detail significant emerging technology and market trends that pharma executives need to understand if they are to manage the opportunities and challenges that lay ahead. These concise and highly focused reports:
All Contents Copyright © 2021 Doctor's Guide Publishing Limited All Rights Reserved