Connecting your employees to transformative care
While new gene therapies are curing devastating illnesses, they can be some of the most expensive treatments in the world. Our Gene Therapy Solution works as a provision of our stop loss policy to ensure your employees and their family members have coverage for the best possible treatments while protecting your company’s financial security. We don’t stop there. Not only do we cover the treatment, but we also cover the medical costs.
By bringing together health services, medical management, and specialty pharmacy expertise, we take a whole-health approach to address your employees’ unique needs, so they can navigate their health experience with confidence and hope.
Breakthrough gene replacement therapies are anticipated to:
in estimated gene therapy
costs by 20321
new gene therapies to receive
FDA approval each year by 20262
in potential cost
of a single claim3
Working together to change lives for the better
With over 4,000 gene therapies in line for approval, employers are able to offer employees the best in
modern medicine.4
Anthem’s Gene Therapy Solution includes emerging
FDA-approved clinical treatments with strong potential
for high effectiveness in treating difficult rare conditions.
A whole-health approach to gene therapy treatments
Applies to the Gene Therapy Solution that includes an Anthem medical plan.
Gene therapy is an evolving treatment for rare disorders caused by a missing or faulty gene. It may involve addition, inhibition, editing, or functional replacement of a gene. Gene therapies can be one-time treatments and target the genetic root cause of the disease. These treatments are administered in hospitals as infusions, so they fall under medical coverage instead of pharmacy.
Beqvez™
Casgevy™
ElevidysTM
Hemgenix®
Lenmeldy™
Luxturna®
Lyfgenia™
RoctavianTM
Skysona®
Zolgensma®
Zynteglo®
Source: U.S. Food & Drug Administration: fda.gov/vaccines-blood-biologics/cellular-gene-therapy-products/approved-cellular-and-gene-therapy-products.
Learn more about our Gene Therapy Solution:
Healthcare Innovation:
New Gene Therapies Spark Transformative Healthcare Changes
Healthcare Innovation:
Preparing For The Next Wave Of Promising Gene Therapies article
Together, we can help your employees live longer and healthier lives while helping you successfully manage costs.
1 Institute for Clinical and Economic Review (ICER): Managing the Challenges of Paying for Gene Therapies (April 2024): https://icer.org.
2 Carelon: Q2 2004 CarelonRx Drug and Biologic Pipeline Update (May 23, 2024): carelonrx.com/perspectives/2024-q2-carelon-rx-drug-biologic-pipeline-update.
3 Projection based on retail drug cost and possible additional expenses as a result of receiving treatment.
4 American Society of Gene + Cell Therapy (ASGCT): Gene, Cell, + RNA Therapy Landscape Report: Q1 2024 (accessed July 2024): asgct.org.
In California Anthem Blue Cross is the trade name of Blue Cross of California, Inc. Also serving California: Anthem Blue Cross Life and Health Insurance Company. In 11 northeastern counties of New York Anthem Blue Cross is the trade name of Anthem HealthChoice Assurance, Inc., and Anthem HealthChoice HMO, Inc., and Anthem Blue Cross HP is the trade name of Anthem HP, LLC. Independent licensees of the Blue Cross Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.
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