CareMetx Partners with Emerging Therapy Solutions (ETS) to Address High Cost of Therapy for Rare Genetic Diseases

CareMetx’s subsidiary OutcomeRx Insurance Management Services,LLC will leverage access to the Emerging Therapy Solutions (ETS) nationwide network of over 120 medical centers, in order to bolster their Patient Access to Costly and Curative Therapies (PACCT) product, one designed to help payers manage the sudden, high costs of therapies for rare genetic diseases.

Bethesda, MD, Nov. 03, 2021 (GLOBE NEWSWIRE) — CareMetx, a leading technology-enabled hub services company focused on improving patient access to specialty medications, its subsidiary, OutcomeRx Insurance Management Services, and Emerging Therapy Solutions (ETS), an organization that helps healthcare payers manage the risks associated with high-cost therapies, have announced a relationship to help payers better manage the high costs associated with treatments for rare genetic diseases. 

Through this agreement, ETS will provide best in class cell and gene therapy centers of experience and excellence network access, pipeline forecast analytics, claims repricing services, and expert clinical content, all of which CareMetx’s  subsidiary OutcomeRx Insurance Management Services, LLC  will leverage to optimize their Patient Access to Costly and Curative Therapies  (PACCT) reinsurance offering- one that provides first-dollar coverage to payers (including health plans, reinsurance, and stop-loss carriers) for high-cost specialty drugs, including therapies in the emerging cell and gene therapy market. 

CareMetx President and CEO Mark Hansan shares, “Our team has been working for ten years with pharmaceutical and biotechnology manufacturers to help patients access and afford specialty therapies. We are excited to enhance our innovative reinsurance product in partnership with ETS, to help ensure that families and patients needing these life-changing therapies are not hindered by the cost and coverage of treatment.”

Cell and gene therapies are one of the latest medical innovations used to help treat and potentially cure complex  diseases, and a focus on these treatment methods is quickly expanding. It’s estimated that by 2025, 10- 20 new gene therapies will be approved each year. To give perspective on what the associated cost of this treatment shift would mean for stakeholders and patients, as of today, the cost to treat an individual with gene therapiesranges from $850,000- to $2.1 million- and future cell and gene therapies of this type are estimated to cost $2-3 million. 

Emergency Therapy Solutions was originally founded in 2018 to help payers and other risk-bearing entities prepare for exactly this- the accelerating growth in cell and gene therapy. In 2020, ETS then acquired LifeTrac, a 30-year-old transplant network, adding over 1,000 medical center programs of excellence and experience to its network access services, and over 120 medical center relationships to its growing claims repricing expertise.

“We are thrilled to be working with CareMetx to expand the offerings of their PACCT product,” says Dave McLean, CEO of ETS. “As a fully integrated business, we are now focused on ensuring that payers, reinsurance and stop loss carriers are prepared and have access to these important, approved gene therapies.” 

About CareMetx
CareMetx, LLC is a leading technology-enabled hub services platform facilitating patient access to specialty medications. CareMetx developed OutcomeRx Insurance Management Services to enhance patient access to costly and curative therapies by creating predictable risk exposure for healthcare payers.  Serving pharmaceutical, biotechnology and device manufacturers, providers and payers, CareMetx leverages digital eServices integrated in a cohesive platform to promote efficiency in the healthcare ecosystem and remove barriers for patients and providers. CareMetx is committed to delivering compassionate advocacy to patients, decision-making data and confidence-building insight to clients. Headquartered in Bethesda, Maryland, CareMetx serves more than 80 brands. Learn more at www.caremetx.com

About Emerging Therapy Solutions
Emerging Therapy Solutions® (ETS) helps healthcare payers – including reinsurance and stop-loss payers, health plans and self-funded employers – manage the risks associated with high-cost therapies for rare and complex conditions. ETS offers a comprehensive suite of services for solid organ and bone marrow transplants, cell and gene therapies, and other highly specialized therapies. ETS services include pipeline monitoring, expert clinical and medical coverage content and education; network management and access to contracts at medical center ‘Programs of Excellence’; accurate and timely claims services; and actuarial data analytics and reporting. Learn more at emergingtherapies.com

Contact: Sara Hakanson, Vice President of Marketing- sara.hakanson@emergingtherapies.com