Commercial Gene Therapy Options/Disrupters
by Member & Community Relations Team

It has been a very busy and interesting year in the Payer space. With the recent approval of gene therapies for Hemophilia A and B and a pipeline with several other novel therapies, we are seeing new market entrants offering networking and contracting services to a variety of payers in the market.

New entrants offering a hemophilia solution include Evio, Emerging Therapy Solutions (ETS) and Synergie Medication Collective that have entered the bleeding disorders space for network contracting specific to Gene Therapy. These companies have created an opportunity and a threat for HTCs. The Hemophilia Alliance Team has been meeting with these companies to discuss the US Hemophilia Treatment Center Network and its expertise along with the national network contracting options with Hemophilia Alliance Network Services (HANS) for Gene Therapy and other bleeding disorder medications as needed. Having participating contracts with these companies will create an opportunity for HTCs to establish an HTC Centers of Excellence Network for Gene Therapy and at the same time secure network access for other bleeding disorders medications.

In addition to the above networks, an entity called Free Market Health (FMH) has emerged as another disruptor in our bleeding disorder product market. FMH is currently working with Highmark Blue Cross and Blue Shield and Blue Cross and Blue Shield of North Carolina. While the way they intersect with providers is dictated by the respective Plan, FMH’s core business is to establish an online “bidding process” for certain specialty medications (including clotting factor) in a short window of time. This enables the Plan to achieve savings by weeding out high-cost distribution sites rather than explicitly creating a select network. The HANS team is working closely with FMH to understand the model and its potential threat to current HTC volume as well as opportunity to access new volume.

If your HTC or institution has been meeting with these organizations, please contact Jeff Blake at jeff@hemoalliance.org so we can have a solid coordinated effort.