More than ten cell and gene therapies have been approved by the FDA in the past five years,1 and over 500 gene-based therapies are in clinical development2 as of 2023.
Scientific advances in understanding how to manipulate genes to alter the course of disease are now starting to bear fruit.
States are using several different models to extend VBP strategies into their drug purchasing.
President Trump’s “American Patients First” blueprint outlines several initiatives to lower drug prices and reduce patients’ out-of-pocket costs.
Prescription drug coverage is an optional benefit under Medicaid, but all states currently provide this coverage.
State Medicaid programs continue to balance serving eligible beneficiaries and controlling costs.
Program integrity includes activities to prevent, detect and respond to fraud, waste, abuse and noncompliance with certain contractual or other regulatory requirements that result in improper payments.
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There is a growing trend among states to develop more rigorous methods for overseeing and enforcing contract requirements with Medicaid managed care organizations (MCOs).