Jan 14, 2020

Health care industry grapples with staggering gene therapy costs

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Data: CVS Health; Table: Axios Visuals

The gene therapy pipeline contains several drugs that are likely to cost the health care system billions of dollars in the near future, according to an a new CVS white paper.

The big picture: Drugmakers are already having to come up with creative ways to get paid for high-cost drugs, the Wall Street Journal reported yesterday, and that's before these new gene therapies hit the market.

Why it matters: These therapies will provide medical miracles to patients who have long gone without cures for debilitating diseases. Some may even save money in the long run, compared with the cost of lifelong treatment.

  • But our health care system isn't built to absorb these kinds of upfront costs.
  • The impact will be especially potent for small employers, which could be bankrupted by one sick employee who receives one of these therapies.

What's next: CVS is developing an additional insurance product that it says will help small employers guard against this, among other solutions it outlined in the white paper.

The bottom line: Policymakers are stuck on how to deal with existing prescription drug prices, but the private market is beginning to at least grapple with how it will handle the cost of future drugs.

Go deeper: Gene therapies' accessibility problem

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A new multimillion dollar drug

A lab tech thaws a blood bag before genetically modifying a patient's immune cells. Photo: Gerard Julien/AFP via Getty Images

BioMarin Pharmaceutical is eyeing a $2 million–$3 million price tag for its hemophilia gene therapy if it's approved, which could make it the world's most expensive drug, the Wall Street Journal reports.

Why it matters: It's a good reminder that today's pipeline is likely to cause a giant shock to the health care system over the next few years.

Go deeperArrowJan 17, 2020

When a generic drug doesn't do much to lower costs for patients

Photo: Shana Novak/Getty Images

A generic version of Copaxone, one of the most popular drugs to treat multiple sclerosis, didn't do much to lower costs for patients, NPR reports.

The big picture: MS drugs cost $70,000 a year, on average, and some prices have increased to five times what they were when the drugs were first approved by the FDA.

Go deeperArrowJan 21, 2020

FDA defends its drug approval process after controversial reviews

FDA headquarters. Photo: Al Drago/CQ Roll Call

Many experts have questioned the FDA's drug approval standards over the past few years, as several controversial drugs have gotten the green light despite less rigorous testing.

What they're saying: Peter Stein, the head of the FDA's office that analyzes new drugs, sat down with Zachary Brennan of Regulatory Affairs Professionals Society and said the only thing that's changed with the FDA's approval process is a shift in the types of drugs the agency is reviewing.

Go deeperArrowFeb 11, 2020 - Health