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Monday, Jan 22 2024

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Blue Cross Insurers Will Be First To Cover New Sickle Cell Gene Therapies

Also in the news, Wagner's TLPO cancer vaccine with minimal side effects is nearing phase 3 clinical trials; the rise of telehealth sales of Ozempic; overdose calls for Ozempic and Wegovy are spiking; and HHS has banned Elizabeth Holmes, founder of blood test firm Theranos, for 90 years.

Blue Cross Blue Shield insurers have become the first carriers to cover multimillion-dollar new gene therapies for sickle cell disease, and other insurers and Medicaid agencies are moving to follow suit. Blue Cross' Synergie Medication Collective has inked risk-sharing agreements with drugmaker BlueBird Bio to offer its $3.1 million Lyfgenia gene therapy treatment for sickle cell disease to some self-insured employers, as well as competitor Vertex Pharmaceuticals' $2.2 million Casgevy treatment. (Tepper, 1/19)

More pharmaceutical industry developments —

Dr. Thomas Wagner, founder of the biotech company Orbis Health Solutions and cancer researcher, has made it his life's mission to find a way to treat cancer without the dreaded side effects that, for some, can become worse than the cancer itself or may even lead to an earlier death. ... Wagner's TLPO cancer vaccine has been tested in hundreds of patients with advanced forms of melanoma in Phase 2 clinical trials. The most recent data presented at an academic conference showed nearly 95% of people given only the vaccine were still alive three years after starting treatment and 64% were still disease-free. (Cobern, 1/20)

The rising popularity of glucagon-like peptide agonists has led to a gold rush of companies offering telehealth weight-loss services. GLP-1s, a class of medications that can help with weight loss and diabetes, have become big business in a short period of time. Drugmaker Novo Nordisk, which manufactures injectable GLP-1 agonist medications Ozempic and Wegovy, booked more than $12 billion in revenue in 2023's first nine months from those two drugs alone. (Perna, 1/19)

As the popularity of semaglutide weight-loss medications continues to grow, so does the rate of potentially dangerous overdoses, experts are warning. Reported overdoses of semaglutide products such as Ozempic and Wegovy more than doubled between 2022 and 2023, according to America’s Poison Centers in Virginia. "U.S. Poison Centers have documented 3,316 exposures to products containing semaglutide through Dec. 31, 2023, more than two times the number of cases reported in 2022," Dr. Kait Brown, clinical managing director of America’s Poison Centers, told Fox News Digital via email. (Rudy, 1/21)

HHS has banned Elizabeth Holmes, incarcerated founder of blood-testing company Theranos, from participating in any federal healthcare program for the next 90 years. According to a Jan. 19 news release from HHS' Office of Inspector General, Ms. Holmes will be unable to bill Medicare, Medicaid or any other federal program. Ms. Holmes is currently serving an 11-year prison sentence after being convicted of defrauding investors in Theranos. The company claimed to be able to screen for hundreds of conditions with a single drop of blood. (Wilson, 1/19)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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