Upcoming Expensive New Therapeutics Weigh Heavily on Medicaid Programs

After the recent approvals of expensive biologics, the impact on Medicaid is unclear. Medicaid must pay for drugs that have been approved by the US Food and Drug Administration (FDA), although Medicare will likely pay the lion’s share of the cost. Other potential blockbusters in the pipeline are also looming large.

According to Megan R. Wilson, “One example is Zynteglo, which the FDA approved in August as the first cell-based gene therapy to treat beta thalassemia, a blood disorder that can require regular red blood cell transfusions. Donna Sullivan, the Washington State Health Care Authority’s chief pharmacy officer, told Lauren her state had identified about five or six Medicaid clients who are transfusion-dependent and could be candidates for the treatment, which has a list price of $2.8 million for a one-time treatment.”

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(Source: Politico, October 12^th, 2022)