Opinion: How will we pay for the coming generation of potentially curative gene therapies?

We have arrived at a special moment in health care. Innovative, life-changing gene therapies are here that will cure or ease debilitating diseases. Yet these expensive treatments are entering a market structure that was not built to price them.

Congress will likely need to play a part in developing a new paradigm for financing such treatments. As a senator and a physician, I have been following this issue closely, and see several possible paths forward. There are multiple issues to address.

First, the current model places the responsibility for purchasing treatment on a patient’s health insurer at the time of the treatment. Gene therapies can carry multimillion-dollar price tags. Although they may actually save money in the long run compared to the health care costs associated with the diseases they treat, those savings might not accrue to the initial payer because patients often change health insurers. This model would incentivize an insurer to cover the therapy,