The World of High-Cost Cell & Gene Therapies (CGTs): Breakthrough Therapies at a Breaking Point

The era of “pills in a bottle”—dominated by small molecule drugs for chronic conditions—has given way to innovative biologics, specialty drugs, and most recently, cell and gene therapies targeting rare, orphan, and complex diseases. Some of these new therapies offer the potential for one-time, curative treatments but come with unprecedented price tags. This Snapshot, in combination with the Employer Action Brief, provides information on the growing marketplace for Ultra-High-Cost Therapies (UHCTx), along with existing and emerging cost challenges and opportunities, current finance and coverage models, and what the future landscape looks like.

Managing Cell & Gene Therapies for Rare & Orphan Diseases & High-Cost Therapies: Real Employers & Real Solutions

This Employer Action Brief serves as a companion resource to the Employer Snapshot, providing information on the evolving marketplace and evolution of Ultra-High-Cost Therapies (UHCTx). It is part of MBGH employer-directed research project that tapped into insights, stories and perspectives from leading health benefits professionals as an outcome from Workstream 1. Moving forward, in Workstream 2, MBGH will continue to support employers in identifying the current finance and coverage models for UHCTx, emphasizing solutions that are effective and innovative for employers to embrace, and address potential impacts to the health plan.