Toward Equitable Access to Cell and Gene Therapies: Rethinking Co-Payments
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High co-payments for cell and gene therapies create access barriers, and value-based insurance design is proposed to eliminate patient cost sharing. These therapies, priced above $3 million, pose significant affordability and equity challenges in the US healthcare system.
Cell and gene therapies offer potentially curative treatments for inherited disorders and certain cancers, but their high prices create access barriers. In the US, these therapies are often priced above $3 million, posing significant affordability challenges. Patient cost sharing, including deductibles and coinsurance, can expose insured patients to thousands of dollars in out-of-pocket costs. This can lead to financial strain, medical debt, and bankruptcy for patients and families. Value-based insurance design is proposed to eliminate patient cost sharing for these therapies, promoting equitable access. The US healthcare system must address these challenges to deliver these life-changing treatments to those who need them.
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