‹ View All Resources

CGT Solutions Acquires OutcomeRx to Advance Next Generation Reinsurance and Warranty Products

Press Release

Bethesda, Maryland, May 15, 2023 (GLOBE NEWSWIRE) — CareMetx, LLC, a leading technology-enabled hub services company focused on improving patient access to specialty medications, announced the sale of OutcomeRx, a division of CareMetx. OutcomeRx was formed in 2019 to address the patient, manufacturer, and payor challenges in the evolving Cell and Gene Therapy (CGT) market.

OutcomeRx offers its reinsurance solution to payors and other risk bearing entities so covered members receive personalized treatment and care management at credentialed Centers of Excellence. Additionally, payors and manufacturers can utilize OutcomeRx’s warranties to align clinical and financial outcomes. These solutions are particularly valuable with the growth of the Cell and Gene Therapy market which is expected to reach $17.2 billion1 by 2027.

“The cost of these therapies, often upward of 2 to 3 million dollars per patient, necessitates financial and risk predictability for both primary and secondary payors. There is enormous opportunity to make these life-saving therapies accessible to covered members,” says Joe Morse, CEO of the newly founded CGT Solutions. He continues, “With bespoke solutions designed by OutcomeRx, we’re able to provide the reinsurance and warranty of cell and gene therapies to deliver patient access and superior clinical and financial outcomes.”

“CareMetx’s support for the solutions offered by OutcomeRx is steadfast. We believe that this acquisition ensures that the continued commercialization of such solutions is assured,” says Jim Rowe, CEO of CareMetx which retains a minority interest in OutcomeRx. Brooks Wildasin, who oversaw the launch of OutcomeRx’s Therapy Warranty and Patient Access to Costly and Curative Therapies (also known as PACCT), will continue to manage the product portfolio as EVP and Chief Underwriting Officer. In addition, CareMetx Co-founder and Executive Chairman Mark Hansan will serve on the Board of Directors of CGT Solutions. 

About CareMetx

CareMetx, LLC is a leading technology-enabled hub services company facilitating patient access and adherence to specialty medications. Serving pharmaceutical and biotechnology manufacturers, CareMetx leverages a digital front-end, proprietary automation, an integrated platform, and best-in-industry call center services 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 manufacturer clients. Headquartered in Bethesda, Maryland, CareMetx serves more than 80 brands. Learn more at caremetx.com and follow us on LinkedIn at https://www.linkedin.com/company/caremetx-llc.

About CGT Solutions

CGT Solutions, LLC serves to accelerate patient access to potentially curative therapies. Through our innovative operating company, OutcomeRx Insurance Management Services, LLC and its strategic partners, payors receive best-in-class underwriting, actuarial, and clinical resources so covered members can access novel cell and gene-based therapies. We advocate that covered members have no financial cost share. We enable economic and clinical outcome alignment between payors and manufacturers by providing therapy-specific warranty programs. Our patient-centric solutions are built on the trust we establish in every relationship and driven by service excellence to achieve our mission. Learn more at OutcomeRx.com.

1Gene Therapy Market, Published: Jul 22| Report Code: BT7506. https://www.marketsandmarkets.com/Market-Reports/gene-therapy-market-122857962.html#:~:text=The%20global%20Gene%20Therapy%20Market,18.6%25%20from%202022%20to%202027.

Download the case study PDF to read more