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®
Zynteglo®
Zolgensma®
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.
Anthem Blue Cross and Blue Shield is the trade name of: In Colorado: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. In Connecticut: Anthem Health Plans, Inc. In Indiana: Anthem Insurance Companies, Inc. In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. and Community Care Health Plan of Georgia, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc., dba HMO Nevada. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. HMO plans are administered by Anthem Health Plans of New Hampshire, Inc. and underwritten by Matthew Thornton Health Plan, Inc. In 17 southeastern counties of New York: Anthem Healthchoice Assurance, Inc., and Anthem Healthchoice HMO, Inc. In these same counties Anthem Blue Cross and Blue Shield HP is the trade name of Anthem HP. LLC.In Ohio: Community Insurance Company. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield, and its affiliate HealthKeepers, Inc. trades as Anthem HealthKeepers providing HMO coverage, and their service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. In Wisconsin: Blue Cross Blue Shield of Wisconsin (BCBSWI), underwrites or administers PPO and indemnity policies and underwrites the out of network benefits in POS policies offered by Compcare Health Services Insurance Corporation (Compcare) or Wisconsin Collaborative Insurance Corporation (WCIC). Compcare underwrites or administers HMO or POS policies; WCIC underwrites or administers Well Priority HMO or POS policies. Independent licensees of the Blue Cross and Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.
1043338MUEENABS Rev. 7/24