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Rx Insights: Gene Therapies

Promising treatments, with costly and complex side-effects

“Highly selective gene therapies mean very few people will actually benefit from treatment. Ensuring the right drug for the right member through appropriate management programs is Wellmark’ strength.” — Matt Hosford, vice president and chief pharmacy officer at Wellmark Blue Cross and Blue Shield.

There is a lot of buzz emerging around gene therapy — the new, breakthrough therapy using different mechanisms to change or modify an individual’s genes to prevent, cure or treat a disease.

With these complex therapies, there are several factors to consider since they only target a small pocket of patients with rare conditions—gene therapies typically require highly specialized care and administration and careful patient monitoring.

As these therapies become more available to your employees, they tend to carry price tags of hundreds of thousands of dollars for one-time treatments — making it complicated for your business from a cost-savings and administrative viewpoint.

With Wellmark, you get more. Through our Pharmacy and Therapeutics (P&T) committee, and partnership with CVS Health®, you and your employees can feel confident knowing these new therapy approvals will be monitored and that the best, most cost-effective options will be provided from being prescribed to when purchased at the counter.

Learn more about gene therapy treatment External Site Opens PDF in the CVS Insights Briefing.