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Issue Brief: Medicaid Barriers to Accessing Cell & Gene Therapies

Federal law requires that U.S. Food and Drug Administration (FDA) approved drugs subject to a rebate agreement be covered by each state Medicaid program upon availability. Medicaid is an important payer for cell and gene therapies, including many approved therapies that treat rare genetic diseases affecting children and potential approvals for sickle cell disease and other severe conditions on the horizon. A recent analysis found several barriers to access at the state level for cell and gene therapies (CGT) for patients and providers given the lack of state resources and policies in this burgeoning area.

ADVI Health reviewed Medicaid access barriers in CGT and conducted interviews with Alliance for Regenerative Medicine (ARM) member organizations that have currently marketed products to assess the state Medicaid CGT landscape.

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