The Centers for Medicare & Medicaid Services (CMS) reported in a press release that more than half of the U.S. states and District of Columbia and Puerto Rico have committed to the Cell and Gene Therapy (CGT) Access Model.
The goal of the model is to broaden sickle cell disease care for patients with Medicaid. According to CMS, “participating states represent approximately 84% of Medicaid beneficiaries with the condition.” The states will obtain discounts and rebates from certain CGT manufacturers “if the therapies fail to deliver their promised therapeutic benefits.”
In addition to the agreements with CGT manufacturers, participating states will also receive: Up to $9.55 million in funding if needed, a year to begin participation (January 2025-2026), and the possibility of adding other diseases to the model in the future. CMS emphasized that participation in the model “is voluntary for states and manufacturers.”
