Progress with Gene Therapies Requires Medicare Reform

January 29, 2021

Novel therapeutic approaches, although promising in the personalized medicine space, remain hampered by cost issues when it comes to Medicare paying for the treatment. Due to these financial considerations, the implementation of new therapies, such as CAR-T cell therapy, is falling behind. Jeet Guram, M.D., currently a visiting scholar at the USC Schaeffer Center for Health Policy & Economics, previously served as Senior Advisor to CMS and the FDA, calls for urgent policy changes.

According to Jeet Guram., M.D., “A comprehensive solution will require legislative change. Congress should pull gene therapies entirely out of Medicare’s buy-and-bill system for hospitals.  A pathway could be created for the government to purchase gene therapies directly from manufacturers for Medicare patients, as the government has done for all doses of COVID-19 monoclonal antibody therapies and vaccines.  A more nimble approach is urgently needed, as science is moving faster than Medicare’s payment policies.” Learn more here.

(Source: Jeet Guram, M.D., USC Schaeffer Center for Health Policy & Economics, 1/28/21)

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