Symposium: Able to Cure, Able to Pay — Closing the Widening Gap

Hepatitis C Virus (graphic by the Centers for Disease Control and Prevention)

In Louisiana, there are roughly 39,000 people eligible for state-sponsored health care who are living with hepatitis C, a blood-borne virus that can lead to chronic liver disease. The state’s significant prevalence of cases and high treatment costs has led them to turn to an innovative idea – using a Netflix-style subscription model to pay for curative hepatitis C medicines.

Like Netflix—where you can watch all of the movies that you want each month for one price – Louisiana will be able to access all the hepatitis C medicines it needs under a fixed cost, five-year contract with Gilead Science’s authorized generics subsidiary, Asegua Therapeutics. Gilead is among several innovative biopharmaceutical companies that developed treatments that cure the disease.

This unique payment model will be a central part of an pre-conference symposium on Sunday, May 19 at 5:30 p.m. CT at the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Annual Meeting in New Orleans, Louisiana. Sponsored by the National Pharmaceutical Council (NPC) and moderated by its chief science officer, Robert W. Dubois, MD, PhD, the symposium features Alexander Billioux, MD, Louisiana Department of Health's Office of Public Health, who has a leading role in his state’s novel payment efforts; Vadin Lubarsky, MBA, Novartis Services, Inc., who has developed financial contracts with payers; and Mark Trusheim, MSc, MIT NEWDIGS, who is developing and testing creative financing models.

There are other organizations, including the state of Washington, that are testing similarly unique arrangements, recognizing that curative therapies, especially for diseases with a high prevalence, can be challenging for health care budgets. With “one and done” types of treatments—those that are used over a short-term for lifetime effects—the question about who pays and who benefits is always front and center. With nearly 60 of these treatments expected to reach the market by 2030, the issue is even more pressing. That’s why MIT’s NEWDIGS FoCUS (Financing and Reimbursement of Cures in the US) program, supported by NPC, has been testing creative financing models such as performance-based annuities for treatments of blood disorders, milestone-based rebates for chimeric antigen receptor T-cell (CAR-T) therapies, and the creation of an orphan reinsurer benefit manager for orphan/ultra-orphan diseases.

Along with the Netflix model, these leading-edge approaches will be among the topics discussed during the ISPOR session.

The ISPOR session is open to registered meeting attendees.