‘Outlook’ urges health systems to prepare for cell and gene therapy expansion

Vizient, Inc. released its summer Pharmacy Market Outlook estimating the 2025 overall drug price inflation rate for pharmaceuticals at 3.81% based in part on expanding indications of previously approved medications, such as semaglutide, which increased 77% in spend since the summer 2023 Outlook. The report also urges providers to prepare for an increased number of high-cost cell and gene therapies entering the market that will significantly impact provider budgets and operational processes. View the summer 2024 Pharmacy Market Outlook.

Currently, FDA-approved gene and cell therapies range in annual wholesale acquisition cost (WAC) from $250,000 to $4.25 million for a single dose. Recently approved gene therapies, ranging from $2 million to $4.25 million in WAC, include treatment indications for inherited blood disorders such as sickle cell anemia and beta-thalassemia and pediatric neurological conditions including Duchenne muscular dystrophy, spinal muscular atrophy, pre-symptomatic late-infantile and early, active cerebral adrenoleukodystrophy. The Outlook notes that there are close to 300 cell and gene therapies currently in clinical trials across several disease states.

“Gene and cell therapies present budgetary, operational and revenue obstacles that require health systems’ multidisciplinary teams and processes to quickly identify qualified patients, access treatments and synchronize logistics for drug administration,” said Carina Dolan, associate vice president, clinical oncology, pharmacoeconomics and market insights, Vizient. “Providers should be organizing cross-functionally now to prepare for these novel therapeutics and planning a long-term approach to properly manage them.”

In the oncology class, chimeric antigen receptor T-cell (CAR-T) therapy, used in the treatment of blood cancers, has grown exponentially since its first introduction to the market in 2017. Today there are six CAR-T agents with indications for several types of lymphoma, myeloma and now chronic lymphocytic leukemia. Five of these products experienced a 9% WAC increase since November 2023, and one product had a 7% price increase. All six are priced at more than $455,000 per treatment.

In late 2023, a recent competitor to CAR-T, bispecific T-cell engagers, surpassed CAR-T usage, according to a Vizient Clinical Data Base analysis. Currently, there are nine approved bispecific T-cell engager products ranging in WAC from $9,715 for weekly treatments to $360,500 for a full treatment course. The most recent bispecific T-cell engager approved by the FDA was for tarlatamab (Imdelltra™, manufactured by Amgen) in May 2024, for patients with extensive-stage small cell lung cancer.

Newly granted indications for GLP-1s, semaglutide spend up 77%

The expanding indications for GLP-1 agents, semaglutide (Ozempic® and Wegovy®, manufactured by Novo Nordisk) and newly launched tirzepatide (Mounjaro® and Zepbound®, manufactured by Lilly), is becoming increasingly significant for providers as they manage pharmacy spend. These medications not only treat diabetes and obesity but have recently been approved by the FDA to reduce the risk of major adverse cardiovascular events in overweight or obese adults with established cardiovascular disease. Semaglutide, No. 5 on the list of top medication spend among Vizient pharmacy program participants and up 77% in spend compared to the 2023 summer Outlook, leads the list of endocrine and metabolic medications.

“With the integration of GLP-1s into standard care protocols, future incidence of conditions like myocardial infarction and stroke could be altered by these chronic, lifetime management therapy plans,” Dolan said.

The summer 2024 Pharmacy Market Outlook represents Vizient’s best estimate of the change in the price of pharmaceuticals that Vizient customers will purchase through the Vizient pharmacy program between Jan. 1 and Dec. 31, 2025, based on products purchased from April 1, 2023 through March 31, 2024.

Learn more about the Pharmacy Market Outlook.

About Vizient, Inc.

Vizient, Inc., the nation’s largest provider-driven healthcare performance improvement company, serves more than 65% of the nation’s acute care providers, which includes 97% of the nation’s academic medical centers, and more than 35% of the non-acute market. Vizient provides expertise, analytics and consulting services, as well as a contract portfolio that represents $140 billion in annual purchasing volume. Solutions and services from Vizient improve the delivery of high-value care by aligning cost, quality and market performance. Headquartered in Irving, Texas, Vizient has offices throughout the United States. Learn more at www.vizientinc.com.

Donna Ledbetter (972) 830-6321 donna.ledbetter@vizientinc.com