The recent approval of two gene therapies to address sickle cell disease has infused a sense of optimism among patients grappling with this debilitating condition, particularly prevalent among Black individuals and people of color.
However, health authorities are now confronted with the daunting task of ensuring fair access to these expensive treatments.
For individuals like Michael Goodwin, living with sickle cell disease has meant enduring recurrent, excruciating pain episodes, disrupting both work and family life. Goodwin, now 36, shares, “I can be in the hospital 20 days out of the month sometimes.” This reality has become even more challenging as he’s grown older and started a family.
Despite the promise of the new gene therapies, Goodwin hesitates to pursue them due to the extensive medical preparation required, including chemotherapy, to ready the patient’s bone marrow stem cells for gene editing. Additionally, concerns about the hefty price tags loom large, with Vertex Pharmaceuticals’ Casgevy priced at $2.2 million and Bluebird Bio’s Lyfgenia at $3.1 million.
Dr. Julie Kanter, overseeing the Adult Sickle Clinic at the University of Alabama at Birmingham, notes the expected reluctance among patients, estimating that even if access were readily available, only about 10% might opt for the therapy initially, citing current capacity constraints.
According to estimates from the Centers for Disease Control and Prevention, over 100,000 Americans live with sickle cell disease, with a significant portion covered by Medicaid. However, establishing the necessary infrastructure to administer these novel treatments nationwide will take time.
State and federal officials are grappling with the financial implications, recognizing that conventional budgetary allocations cannot accommodate the costs alone. The Biden administration is initiating negotiations with pharmaceutical companies to secure discounts for Medicaid plans, with payment tied to patient outcomes.
While these discussions unfold, pharmaceutical companies are actively engaging in educational efforts targeting both medical practitioners and patient communities. Vertex and Bluebird Bio anticipate the first patients receiving treatment shortly, marking a significant step forward in the battle against sickle cell disease.
