Cencora’s FormularyDecisions Introduces Payer Resource for Cell and Gene Therapy Products

Amidst the growing landscape of cell and gene therapy (CGT) products in clinical development, Cencora’s FormularyDecisions has unveiled a new resource tailored to offer healthcare payers centralized access to information on approved therapies and those in the pipeline.

FormularyDecisions, a secure online platform, aims to equip healthcare decision-makers in the United States with evidence-based resources while facilitating information exchange between biopharma companies and payers. Through this dedicated CGT resource, registered healthcare payers—representing over 269 million covered lives—gain access to a comprehensive overview of the CGT landscape. This includes detailed product-based information such as clinical evidence, health economic data, launch status, and FDA designations.

Melissa McCart, Vice President of Commercialization Strategy & Access Solutions at Cencora’s Market Access and Healthcare Consulting team, underscores the significance of such a resource in navigating the unique challenges presented by cell and gene therapies. These therapies hold immense promise but also pose challenges to payers due to factors like cost, one-time administration, and limited durability data upon regulatory approval. FormularyDecisions aims to empower payers with the necessary information to assess a product’s value and make informed coverage decisions.

According to the Alliance for Regenerative Medicine (ARM), there are nearly 2,000 CGT clinical trials underway globally, with projections indicating as many as 17 regulatory decisions on CGTs across the United States and Europe in 2024.

Cencora’s Managed Care Network survey reveals that, to date, most payers have developed individual coverage policies for CGT products or assessed coverage on a case-by-case basis. Key evidence identified by payers to inform coverage decisions includes safety and efficacy compared to approved therapies, guideline listings, and real-world evidence.

Lung-I Cheng, Vice President and Head of Cell & Gene Therapy Service Line at Cencora, emphasizes the importance of early dialogue between CGT developers and payers to address concerns and priorities. FormularyDecisions, whether pre-approval or post-launch, serves as a valuable tool to engage payers and communicate product value information effectively.

This launch reflects Cencora’s commitment to introducing solutions that cater to the needs of biopharma partners, healthcare providers, payers, and patients, advancing innovation and access to these transformative products.

In addition to Formulary Decisions, Cencora recently launched a CGT Integration Hub, connecting provider-facing platforms with patient services support programs to streamline the therapy development and delivery process, enhancing visibility across the path-to-care.

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