Perspectives on Payment Policies for Gene Therapies

Tuesday, November 5 | 9 a.m.–5 p.m. | The Westin City Center, Washington, D.C.

This program will address the status of legislative and regulatory solutions to the primary challenges in paying for gene therapies for different payer types (Medicaid, Medicare, and commercial payers), as well as the current state of Medicaid reimbursement policies for these therapies.

Objectives:

1. Discuss recent progress in efforts to enable and utilize novel payment models for gene therapies
2. Explore the status of Medicaid policies for gene therapies and opportunities for enhancing reimbursement mechanisms
3. Identify the implications of recent decisions on Medicare coverage and reimbursement of CAR T-cell therapies

Full Agenda

Value of Gene Therapy & Significance of the Issues
9-10:35 a.m.

• David Barrett, J.D.—Introduction and Keeping Current on the Pipeline
  Executive Director, American Society of Gene & Cell Therapy
• Colin Young, Ph.D.—Preparing the System: Pipeline Prediction Update
  Director of Drug Development Pipeline Research, MIT NEWDIGS
• Jenn McNary—Parent and Patient Advocate Perspective on Value for Duchenne Muscular Dystrophy
  Parent and advocate for people with DMD; Manager, J McNary Consulting
• Khrystal Davis, J.D.—Parent and Patient Advocate Perspective on Value for Spinal Muscular Atrophy
  Parent and advocate for people with SMA; Founder & President, Texas Rare Disease Alliance​
• Francis Pang—Market Access and Value Philosophy for Gene Therapies
  Vice President of Global Market Access, Orchard Therapeutics
• Panel Q&A
  Moderator: Paul Melmeyer, Director of Regulatory Affairs, Muscular Dystrophy Association

Advances in Novel Payment Solutions for Public & Private Payors
10:50 a.m. - 12:15 p.m.

• Rob Osborne—Updates on Outcomes-Based and Innovative Payment Solutions
  Vice President of Trade Relations, Accredo Specialty Pharmacy and CuraScript SD
• Tresja Bolt—Novel Payment Approaches: The Experience from Europe
  Head of European Government Affairs and Policy, bluebird bio
• Dan Mytelka—Managing Gene Therapies: The Orphan Reinsurer and Benefit Manager (ORBM)
  Director of Policy and Simulations, MIT NEWDIGS
• Panel Q&A
  Moderator: Janet Lambert, CEO, Alliance for Regenerative Medicine

Legislative Solutions: Novel Payment Mechanisms for Gene Therapies
1:15-2 p.m.

• Anne Dwyer, J.D.
  Senior Health Counsel, Senate Committee on Finance
• Stuart Portman
  Health Policy Advisor, Senate Committee on Finance
• Panel Q&A
  ​​​Moderator: Mark Battaglini, J.D., Vice President, Global Government Affairs & Public Policy, bluebird bio

Deep Dive I: Perspectives on State and Federal Medicaid Policies
2-3:30 p.m.

• Mark McClellan, M.D., Ph.D.—Opportunities and Barries for Advancing Value-Based Payment 
  Founding Director, Margolis Center for Health Policy at Duke University
• Ross Margulies, J.D.—Medicaid Landscape: A Look at State Medicaid Approaches to Gene Therapy Coverage and Reimbursement
  Associate, Foley Hoag
• Kaha Hizanishvili—The Massachusetts Medicaid Approach to Gene Therapy Reimbursement
  Chief, Office of Provider & Pharmacy Programs, MassHealth
• Chethan Bachireddy, M.D.—A Developing Approach to Break-through Therapies: The Virginia Medicaid Experience
  Chief Medical Officer, Virginia Department of Medical Assistance Services
• Panel Q & A
  Moderator: Mark McClellan

Deep Dive II: A Fresh Look at Medicare Reimbursement Policies
3:45-5 p.m.

• Anna Griffin—Developer View: Current and Future Patient Access to CAR T-cell Therapy Under Medicine
  President & CEO, Griffin Consulting
• Jugna Shah—Proposals for CAR T-cell Therapy Reimbursement Beyond the NTAP Period
  President, Nimitt Consulting
• Panel Q & A
  Moderator: Jugna Shah