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Cell and gene therapy approvals will target much larger populations by end of decade

Forty cell and gene therapies may be launched in the coming five years. They could target as many as 33 million patients by the end of this decade. When a single dose of a gene therapy can cost millions of dollars, finding feasible and equitable ways to price and reimburse these products is a major challenge.

Cell and gene therapies began mostly in the ultra-orphan space, but with technological advancements in drug development, therapies are expanding into much larger populations. This evolution began last year with the approval of the CAR-T therapy Carvykti, which may be prescribed to more than 80,000 multiple myeloma patients annually by 2025.

In the gene therapy space, recent approvals of hemophilia A and B products, as well as the imminent launch of sickle cell disease therapies, expand new therapies reach to potentially hundreds of thousands. Then, as we look forward to a few years from now, gene therapies may enter the massive diabetes and osteoarthritis markets, which pushes their impact exponentially to millions of patients annually.

Most cell and gene therapy products are intended as one-time injection treatments, which in turn may offer durable cures. But the up-front costs are very high on a per-unit basis. And questions around the durability of novel gene therapies persist. As such, there are serious concerns about how to manage the considerable costs while ensuring equitable access.

Independent watchdog organization, ICER (Institute for Clinical and Economic Review), is helping to push the movement toward fair pricing and fair access forward—and it’s been shown that cell and gene therapies can be cost-effective. However, for this value proposition to become a universally accepted practice, payers must adopt a view that systematically incorporates the concept of value-based pricing. Traditional methods of reimbursement won’t work. As a consequence, payers will need to implement value-based pricing arrangements, such as pay-for-performance schemes or warranty programs, in which evidence is gathered and analyzed to assess whether cell and gene therapies prove their worth and are durable over time. Policymakers will need to turn to value-based contracting solutions, such as the ones Lyfegen offers.

Both pharma companies and payers are faced with the complex challenge of navigating the uncertainties of drug pricing agreements for cell and gene therapies. Lyfegen is an independent resource that provides powerful tools and resources for pharma and payers to leverage so that the right type of reimbursement model can be identified for a specific cell and gene therapy. The Lyfegen Model & Agreement Library contains more than 2,000 real-world, value-based agreements and 18 drug pricing models from around the world. And the Lyfegen Platform leverages intelligent algorithms to capture and analyze patient-level drug cost data that can then be run through a platform-based simulator to help customers negotiate the best agreements possible.

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Why Q1 Is Critical for Pharma Rebate Management

The first quarter of the year is a pivotal time for the pharmaceutical industry. As budgets are finalized and contracts renegotiated, Q1 sets the stage for how effectively organizations manage rebates, optimize costs, and deliver value.

For those navigating the complexities of pharma rebate management, Q1 offers unique opportunities to streamline workflows, review existing agreements, and ensure every rebate maximizes its potential. This period isn’t just about planning, it’s about implementing smarter processes to stay ahead in an increasingly dynamic healthcare landscape.

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Why Rebate Management Deserves Q1 Attention

Reviewing Performance

Q1 is the ideal time to evaluate rebate performance from the previous year. Were the agreements aligned with expectations? Did they deliver the promised value?

By assessing past performance, teams can identify underperforming agreements and opportunities for improvement. This ensures resources are allocated to agreements that drive measurable results.

Optimizing Current Workflows

Rebate workflows are often complex, requiring significant manual effort for tracking, reconciliation, and reporting. In Q1, organizations have the opportunity to implement systems that:

Reduce administrative burdens.

Automate repetitive tasks.

Provide real-time visibility into rebate performance.

Streamlining workflows early in the year creates efficiencies that save time and resources throughout the year.

Negotiating Future Agreements

The first quarter is also critical for renegotiating rebate terms with manufacturers and payers. Updated contracts may include:

A move to outcome-based agreements, which tie rebates to specific performance metrics.

Adjustments to existing terms based on market changes.

Teams equipped with data from previous agreements are better positioned to negotiate terms that align with strategic goals.
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The Role of Technology in Pharma Rebate Management

Technology is transforming how organizations approach pharma rebate management. Tools like those offered by Lyfegen enable teams to:

Automate workflows: Reduce manual effort in tracking and reconciliation.

Gain transparency: Access clear, real-time insights into rebate agreements.

Optimize decisions: Use data-driven analytics to evaluate and renegotiate agreements.

For example, Lyfegen’s platform simplifies rebate tracking and provides actionable insights, ensuring organizations maximize their rebate potential while minimizing inefficiencies.

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Start your year smarter!

Q1 is the time to rethink and refine your approach to pharma rebate management. With smarter workflows, clearer insights, and a focus on data-driven strategies, your team can unlock measurable savings and operational excellence.

Book a demo today to discover how Lyfegen’s solutions can simplify your rebate workflows and set you up for success in 2025.

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Rethinking Medicine Payments with Smarter Drug Rebate Management Solutions

Rising drug costs continue to challenge healthcare systems worldwide. In the UK, the proposed Voluntary Pricing Access Scheme (VPAG) and the NHS’s Accelerated Access Collaborative (AAC) are clear signals of the need for sustainable, transparent approaches to branded medicine pricing. These frameworks aim to control costs through 2028 while ensuring patient access to innovative treatments. Drug rebate management solutions are key to navigating these evolving frameworks. By automating complex workflows, providing real-time insights, and streamlining rebate tracking, these tools reduce administrative burdens, enhance transparency, and unlock significant cost savings.

Key Benefits of Modern Drug Rebate Management Solutions

Automation Simplifies Operations

Traditional rebate management involves resource-heavy processes prone to delays and errors. Modern drug rebate management solutions automate tasks like reconciliation, reporting, and contract tracking, enabling healthcare providers to focus on negotiating better contracts and ensuring compliance with policies like VPAG.

Transparency Reveals Opportunities

Rebate platforms provide granular visibility into contracts, helping organizations identify cost-effective therapies and maximize rebate potential. This transparency aligns with NHS AAC’s goal of improving value and ensuring public funds are spent efficiently.

Real-Time Data Drives Smarter Decisions

Access to live rebate and claims data allows stakeholders to evaluate agreement performance and adjust strategies quickly. With real-time insights, healthcare providers can ensure rebates are optimized, costs are minimized, and patient access is preserved.

This capability supports NHS AAC’s commitment to accelerating access to innovative medicines while maintaining value for taxpayers.

Faster Auditing Improves Accountability

Delayed reconciliation often creates inefficiencies and compliance risks. Modern drug rebate management solutions provide real-time rebate tracking and payment reconciliation, ensuring accurate auditing and faster resolution of discrepancies. These features are critical for meeting the transparency and accountability goals of initiatives like VPAG.

Why Now?

The VPAG and AAC frameworks prioritize:

Optimizing branded medicine spending while maintaining access to innovation.

Enhancing transparency for payers, providers, and the public.

Redirecting savings to high-impact therapies and improved patient care.

Modern drug rebate management solutions directly address these priorities by simplifying rebate processes, supporting compliance, and enabling healthcare providers to align with evolving regulatory frameworks.

Smarter Practices in Action

Lyfegen is an all-in-one platform designed to streamline rebate workflows, improve transparency, and deliver actionable analytics. By leveraging tools like Lyfegen, healthcare organizations can navigate regulatory changes like VPAG with confidence, ensuring efficient operations and measurable savings.

Looking ahead

As healthcare systems face rising costs and increasing complexity, adopting a modern drug rebate management solution is no longer optional, it’s essential. These tools provide the automation, transparency, and real-time insights needed to comply with frameworks like VPAG while driving cost savings and supporting innovation.

Ready to simplify your rebate workflows? Sign up for a demo today to see how smarter solutions can transform your strategy.

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