A life sciences manufacturer is in a unique position with both potential cell and gene therapies that treat Parkinson’s Disease. This situation presents a series of challenges, including existing access barriers to cell and gene therapy and the complexities of shifting CGT outside traditional transplant-based care. The manufacturer must proactively develop proactive payer strategies, including for Medicare, and mitigation strategies and tactics to address any barriers to access or reimbursement issues.

The Strategy

ADVI was asked by the client to curate, manage, and moderate a cross-departmental workshop focused on the challenges and opportunities of launching cell and gene therapy products for Parkinson’s Disease. In preparation for the workshop, ADVI surveyed internal advisors and external experts across commercial, Medicare, and Medicaid payers, including both fee-for-service and Medicare Advantage, as well as physician and provider stakeholders on their attitudes towards access, pricing, and reimbursement, as well as proper coding considerations. Using this information and in-house expertise, ADVI provided an in-depth landscape assessment as a pre-read. The workshop participants were divided into three groups with representatives from each function to brainstorm access challenges and outline proactive reimbursement and coding solutions for three areas where ADVI identified possible friction.

The Results

ADVI had a successful in-person reimbursement and strategy workshop with the client, offering recommendations and proposing short, medium, and longer-term next steps for the manufacturer as they move forward.

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