Providers and payers must ask themselves a two-pronged question about gene therapy: Who should be treated and when?
The traditional approach for payers, and sometimes for providers, is to start with the least-expensive treatments first and hold off using more expensive ones until later. But when it comes to gene therapy agents that may dramatically alter a patient’s disease for a lifetime of benefit, is that the wrong approach?
Vaccines are a good model for evaluating long-term value in health care. Administered as early in an individual’s life as possible, vaccines prevent disease for decades, or even a lifetime. The costs saved from cases of polio, chickenpox, measles, diphtheria, and the like that never occurred because of vaccines are probably beyond calculation.
Viewing gene therapy in a similar light suggests similar benefits. Why should a patient who is a good candidate for gene therapy experience years of chronic therapy first when the disease could be prevented with an earlier gene therapy intervention?
For some genetic conditions, disease progression may be irreversible, meaning that early intervention is essential to long-term health and cost-effectiveness, avoiding more health care visits, more complications, and more chronic drug therapy compared to later intervention.
Read full, original post: Early treatment with gene therapy: lessons from vaccines