Milliman DNA Gene and Cell Therapy Forecasting
Useful forecasts require robust assumptions
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Milliman DNA related insight
Critical Point: How can Medicaid pay for cell and gene therapies?
Milliman pharmacists and healthcare experts explain what strategies state Medicaid agencies are using for predicting uptake and covering these high costs.
Cell and gene therapies: Informing the uncertainties using research and retrospective claims analysis
Multiemployer pension plans receiving special financial assistance should review the latest key changes to the withdrawal liability, among other recent guidance.
Complexities in forecasting eligible cases and associated costs of cell and gene therapy
Beyond epidemiology, clinical trial criteria, and the science
Prevalence of rare disease in a commercial population using ICD-10 diagnosis codes
This research paper examines the prevalence of rare diseases in a U.S. commercial population using claims data.
Managing risks related to gene and cell therapies for self-insured employers with stop-loss coverage
This paper introduces why self-insured employers with stop-loss coverage may still be exposed to some of the costs of gene and cell therapies, explores considerations and a potential imbalance of financial risk for the self-insured employer and stop-loss carrier when implementing a multiyear performance-based payment arrangement, and discusses potential ways to efficiently contract between the self-insured employer, stop-loss carrier, and manufacturer to better share the financial risk.
An analysis of member retention patterns for adult rare disease cohorts to support evaluating multiyear payment arrangements for novel therapies
Evaluating multiyear payment arrangements? Assess retention rates for patients with rare diseases.
The effect of a pediatric rare disease on subscriber retention rates for commercial health insurers in the United States
Insurers, policymakers, and government agencies in the United States may find it useful to have an accurate expectation for the length of enrollment by subscribers with a dependent who suffers from a pediatric rare disease and may be a candidate for a regenerative therapy with a potentially prolonged benefit.
The uncertainties and benefits of gene and cell therapies: A payer's dilemma
When it comes to gene and cell therapies, there are a number of risks and benefits that payers should consider.