Cell & Gene Therapy | Prime Therapeutics - Prime Therapeutics
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Gene therapy works by repairing or replacing faulty genes to cure or help the body fight disease. Similarly, cell therapy involves the transplantation of healthy cells to replace or repair damaged ones, offering another avenue for treating various conditions. The U.S. Food and Drug Administration (FDA) has approved cell and gene therapy (CGT) products for several conditions, including cancer, spinal muscular atrophy, hemophilia and sickle cell disease.1 CGTs stand apart from traditional drug treatments due to their complex administration methods and costs reaching up to $4.25 million for a single dose gene therapy.2 These therapies present special challenges that must be resolved to make them readily accessible and affordable for patients who need them.3
Several CGTs in development could significantly impact health care costs.4 Although some require multiple doses, many hold the promise to cure intractable diseases with just a single dose. Managing CGT costs requires innovative strategies such as prior authorization, risk carve-outs, value-based contracting and installment payment plans—helping ensure patients can access these life-changing therapies.5
A comprehensive approach to savings
Expertise & predictive analytics
Prime delivers macro- and micro-analytic forecasting predictions, comprehensive pipeline clinical supplements and key opinion leader (KOL) insights when it comes to C>.
Clinical rigor & outcomes tracking
Comprehensive policies, proactive pipeline monitoring and rigorous UM strategies help ensure members get the right therapies. And member-focused outcomes monitoring helps track treatment success.
Risk mitigation
We deliver a host of risk and affordability strategies in partnership with Synergie Medication Collective (Synergie).
Choose what works best for you and your members
Footnotes
*All brand names are property of their respective owners.
**The programs listed are not available to all clients. Please check with your representative if you are interested in learning more.
1 Approved cellular and gene therapy products. August 15, 2025. Accessed in November 2025 at Approved Cellular and Gene Therapy Products | FDA
2 Orchard therapeutics outlines U.S. launch plans for lenmeldy (artidarsagene autotemcel), the only approved therapy for children with early-onset metachromatic leukodystrophy. Mary 20, 2024. Accessed in November 2025 at: Orchard Therapeutics Plans for Lenmeldy
3 Cell & Gene+ – Synergie Medication Collective. (n.d.) https://www.synergiecollective.com/cell-gene/
4 Cell & gene pipeline outlook. Prime Therapeutics. November 12, 2025. Accessed in November 2025 at: Cell & Gene Pipeline Outlook: November 2025 - Prime Therapeutics - Portal
5 Medical Trend Report. 2025 fifteenth edition. Accessed in November 2025 at: Issuu Reader
6 Managine the challenges of paying for gene therapy: strategies for market action and policy reform. April 23, 2024. Accessed in November 2025 at: ICER-NEWDIGS Gene Therapy 2024