Marsh, Octaviant Partner in the Advanced Therapy Guarantee Program | Insurance Business America
Despite the potential to offer cures, advanced therapies come at huge costs
life & health
By Ryan Smith
Global insurance broker Marsh and Octaviant Financial, a provider of novel drug guarantee and payment models, have partnered on a new specialty guarantee program that will enable pharmaceutical companies to expand patient access to gene, cell and specialty therapies.
Such advanced therapies have the potential to cure rare diseases, genetic disorders and cancers in a single-dose regimen, Marsh said. As of 2017, the U.S. Food and Drug Administration has approved 27 such therapies, and thousands more are currently in development or clinical trials.
However, each treatment can cost anywhere from tens of thousands to tens of millions of dollars, which can burden the healthcare system with upfront costs and limit patient access, although the treatments have the potential to reduce overall healthcare costs over time, Marsh said.
Marsh and Octaviant’s program allows pharmaceutical manufacturers to customize and implement therapeutic guarantees to address these concerns. The guarantees provide healthcare payers — including Medicare and Medicaid — with reimbursement in the event that a patient’s advanced therapeutic treatment does not produce the expected results.
The guarantees also comply with the latest guidelines from the Centers for Medicare and Medicaid Services and state regulations, allowing for reimbursement up to the full amount of treatment costs, Marsh said.
The Marsh/Octaviant program also provides pharmaceutical clients with access to proprietary tools and insights, such as therapeutic actuarial services and Octaviant’s precision financing platform.
“To realize the full benefits of these advanced therapies, healthcare payers should have meaningful financial recourse in cases where these therapies are not working as expected,” said Eddit Albers, practice director, US life sciences at Marsh . “A well-structured, compliant guarantee, issued in conjunction with advanced therapy, significantly mitigates this risk. It gives healthcare payers more confidence to cover potentially life-changing therapies, expands access to more patients, and incentivizes manufacturers to develop innovative treatments.”
“Implementing successful therapeutic guarantees requires specific expertise in areas such as corporate strategy, reinsurance and actuarial analysis,” said Emad Samad, CEO of Octaviant. “Our collaboration with Marsh and the larger company Marsh McLennan takes the combined capabilities of both companies and bundles them into one offering. Pharmaceutical manufacturers finally have a platform to create differentiated warranty programs that, unlike current solutions, matter to payers and drive greater uptake of therapies that can save significant costs to the healthcare system and improve patients’ lives.”
The warranty program is available to Marsh’s life sciences customers who are commercializing pharmaceuticals, including advanced gene and cell therapies, Marsh said.
Do you have anything to say about this program? Let us know in the comments below.
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