Sickle cell disease (SCD), which affects over 100,000 people in the U.S., is about to see a major shift in treatment accessibility. With the staggering prices of $2.8 million for LYFGENIA and $2.1 million for CASGEVY, these treatments were inaccessible to many patients.
On November 4th, 2024, The Biden-Harris Administration announced that these treatments would now be covered under Medicare and Medicaid, following agreements with the Centers for Medicare and Medicaid Services (CMS). These life-changing therapies will become more accessible to patients covered by these programs.
Through the establishment of the Cell and Gene Therapy Access Model, the payments for these therapies are designed to tie into health outcomes, ensuring that Medicare and Medicaid recipients can access these cutting-edge treatments without the burden of excessive costs. With this model, payments will be made based on whether the therapy improves patient health, making it a more sustainable and equitable solution for both patients and healthcare systems.
Created: Dec 5th, 2024
Citations:
Centers for Medicare & Medicaid Services. (2024, December 4). Biden-Harris administration takes next steps to increase access to sickle cell disease treatments.
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