Landon Marshall, PharmD, PhD, of Prime Therapeutics, discusses the benefits of gene therapy forecasting for health insurers and what future advancements can be expected.
Landon Marshall, PharmD, PhD, of Prime Therapeutics, explains the benefits of gene therapy forecasting for health insurers and what future advancements can be expected. He discussed the topic further in the AMCP Nexus session, "Gene Therapies: Forecasting Potential Candidates Using Integrated Medical and Pharmacy Claims Data" on October 18.
At Prime Therapeutics, Marshall is a principal health outcomes researcher, focusing on cell and gene therapy, as well as secondary data use to predict future spending trends.
Transcript
With the substantial price ranges of gene therapies, how does having a forecast of gene therapy benefit health insurers in managing financial risks and making informed business decisions?
Currently, the price range of the approved gene therapies that we're forecasting ranges from $750,000 up to over $3 million. Understanding within your book of business, within your membership, your population, how many individuals may be a candidate for that therapy is important for financial risk assessment.
For underwriting, we do present actuaries, so they do use this information, but also, from a clinical standpoint, we want to understand member characteristics and potentially how this would impact current care for those members and also with the future cost and investment that these gene therapies come with.
In the future, what advancements or improvements to gene therapy forecasting can be expected?
We constantly think with the data that we're ingesting that we are improving the forecast. Having conversations with manufacturers really is a transfer of knowledge between the Prime Magellan colleagues and manufacturers.
As we enter additional gene therapies being approved, we'll start to see multiple gene therapies treating the same condition. We'll have to handle that and improve forecasting as we get product differentiation from these competitor products. Also, expecting expanded indications after early accelerated approvals for certain therapies. These are advancements that we're going to have to take in our forecast to maintain it and keep it relevant.
ATS 2024: Bridging the Past, Present, and Future of Respiratory Care
May 16th 2024The application of artificial intelligence in medicine is anticipated as a highlight of ATS 2024, with sessions exploring its applications in research, radiological interpretation, and pediatric pulmonology.
Read More
Frameworks for Advancing Health Equity: Urban Health Outreach
May 9th 2024In the series debut episode of "Frameworks for Advancing Health Equity," Mary Sligh, CRNP, and Chelsea Chappars, of Allegheny Health Network, explain how the Urban Health Outreach program aims to improve health equity for individuals experiencing homelessness.
Listen
Tackling Health Inequality: The Power of Education and Experience
April 30th 2024To help celebrate and recognize National Minority Health Month, we are bringing you a special month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. Welcome to our final episode of this limited series and our conversation with Janine Jelks-Seale, MSPPM, director of health equity at UPMC Health Plan.
Listen
Looking Back on ISPOR 2024: Hot Policy Topics, Welcome Focus on Employers, and More
May 10th 2024Kimberly Westrich, MA, chief strategy officer of the National Pharmaceutical Council, reflects on the most valuable learnings from the 2024 meeting of ISPOR—The Professional Society for Health Economics and Outcomes Research, including lively discussions of the Inflation Reduction Act and workshops on value assessment.
Read More