CMS reaches outcome-based deal with drugmakers to treat sickle cell disease

CMS has reached agreements with drug manufacturers to provide gene therapies to treat sickle cell disease to Medicaid recipients under a new outcomes-based model. 

A total of 33 states, including the District of Columbia and Puerto Rico, have joined a program that ties Medicaid payments to patient outcomes, according to a July 14 news release shared with Becker’s. Under the arrangement, drugmakers will provide discounts and rebates if the treatments do not achieve expected results. 

This marks the first time the federal government has negotiated these contracts on behalf of state Medicaid programs. The participating states account for about 84% of Medicaid enrollees living with sickle cell disease. 

The program provides up to $9.55 million per state with flexible start dates beginning January 2025, the release said.