Dr Landon Marshall Discusses Gene Therapy Forecasting Benefits, Future Advancements

Landon Marshall, PharmD, PhD, of Prime Therapeutics, explains the benefits of gene therapy forecasting for health insurers and what future advancements can be expected. He discussed the topic further in the AMCP Nexus session, "Gene Therapies: Forecasting Potential Candidates Using Integrated Medical and Pharmacy Claims Data" on October 18.

At Prime Therapeutics, Marshall is a principal health outcomes researcher, focusing on cell and gene therapy, as well as secondary data use to predict future spending trends.

Transcript

With the substantial price ranges of gene therapies, how does having a forecast of gene therapy benefit health insurers in managing financial risks and making informed business decisions?

Currently, the price range of the approved gene therapies that we're forecasting ranges from $750,000 up to over $3 million. Understanding within your book of business, within your membership, your population, how many individuals may be a candidate for that therapy is important for financial risk assessment.

For underwriting, we do present actuaries, so they do use this information, but also, from a clinical standpoint, we want to understand member characteristics and potentially how this would impact current care for those members and also with the future cost and investment that these gene therapies come with.

In the future, what advancements or improvements to gene therapy forecasting can be expected?

We constantly think with the data that we're ingesting that we are improving the forecast. Having conversations with manufacturers really is a transfer of knowledge between the Prime Magellan colleagues and manufacturers.

As we enter additional gene therapies being approved, we'll start to see multiple gene therapies treating the same condition. We'll have to handle that and improve forecasting as we get product differentiation from these competitor products. Also, expecting expanded indications after early accelerated approvals for certain therapies. These are advancements that we're going to have to take in our forecast to maintain it and keep it relevant.