Paying for Cures Workshop explores challenges faced by payers, and innovative solutions

Tuesday, March 10, 2020

FoCUS held its second Paying for Cures Workshop at MIT on March 10, this one focused on the challenges payers face when considering new cell and gene therapies. 

The attendees learned and discussed new frameworks available for implementing cutting edge financing agreements and heard from those who are breaking new ground with their unique methods of balancing financing risks with these curative therapies and their potential to end disease. Bringing together a holistic set of insights from patient, payer, provider and developer experiences, this workshop also provided helpful tools that participants can use within their organization as they plan for the future.

Workshop highlights: 

  • Colin Young (Director, Drug Development Pipeline Research, NEWDIGS FoCUS Project) gave an overview of the pipeline of therapies and projected their availability for a range of indications. His analysis helped participants understand the actuarial implications and use the Paying for Cures Toolkit to simulate their own risks, exposure and benefits.
  • Danielle Rollmann (Advisor, NEWDIGS FoCUS Project; Partner, Next Wave Consulting) and Daniel Mytelka (Director, Simulation and Policy Research, NEWDIGS FoCUS Project) gave thorough demos of the online Paying for Cures Toolkit's modeling tools and used case studies to help participants learn how to adapt it to their planning. 
  • A panel featuring Mark Trusheim (Strategic Director, NEWDIGS; FoCUS Project Lead; Visiting Scientist at MIT Sloan School of Management and Moderator), Tim Brent (Senior Director, Business Development, National Hemophilia Foundation), Karen Geary (Vice President, Strategy and Innovation, MedImpact Healthcare Systems, Inc.), Desiree Otenti (Senior Director, Medical Policy and Program Implementation, Blue Cross Blue Shield of Massachusetts), and Ronald G. Potts, MD (Chief Medical Officer, Interlink Health Services) discussed their first hand experience with new financing strategies. Their discussion encompassed choosing the right metrics to determine benefit, how to evaluate value and efficacy, and even what unintended health and economic risks might arise from cures. 
  • Margaux Hall, JD (Health Regulatory Counsel, Hogan Lovells, LLP) and Robert Falb (Director, US Policy and Advocacy, Alliance for Regenerative Medicine) teamed up to talk about the legislative and regulatory landscapes around cell and gene therapies, with a special focus on the complex challenges posed by Medicaid Best Price. 
  • Jane Barlow (Senior Advisor, NEWDIGS FoCUS Project) and Terry Cothran, D.Ph. (Senior Director of Pharmacy, Oklahoma Health Care Authority) discussed how Oklahoma is innovating financing and payment models in the Medicaid space. 

To see the detailed agenda and photos from the workshop, please visit https://www.payingforcures.org/workshop2020/