Abstract
Recently licensed cell and gene therapies have promising but highly uncertain clinical benefits. They are entering the market at very high prices, with the latest entrants costing hundreds of thousands of dollars. The significant long-term uncertainty posed by these therapies has already complicated the use of conventional economic evaluation approaches such as cost-effectiveness and cost-utility analyses, which are widely used for assessing the value of new health interventions. Cell and gene therapies also risk jeopardising healthcare systems’ financial sustainability. As a result, there is a need to recalibrate the current health technology assessment methods used to measure and compensate their value. In this paper, we outline a set of technical adaptations and methodological refinements to address key challenges in the appraisal of cell and gene therapies’ value, including the assessment of efficiency and affordability. We also discuss the potential role of alternative financing mechanisms. Ultimately, uncertainties associated with cell and gene therapies can only be meaningfully addressed by improving the evidence base supporting their approval and adoption in healthcare systems.
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The authors thank James Chambers (Tufts Medical Center), Andrew Briggs (London School of Hygiene and Tropical Medicine), Christopher Carswell (Editor in Chief) and three anonymous reviewers for valuable comments and feedback that helped to improve the manuscript.
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Aris Angelis, Huseyin Naci, and Allan Hackshaw have no conflicts of interest that are directly relevant to the content of this article.
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Angelis, A., Naci, H. & Hackshaw, A. Recalibrating Health Technology Assessment Methods for Cell and Gene Therapies. PharmacoEconomics 38, 1297–1308 (2020). https://doi.org/10.1007/s40273-020-00956-w
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DOI: https://doi.org/10.1007/s40273-020-00956-w