US hospitals using innovative CAR-T treatments are facing additional costs because the health care payment system hasn't evolved fast enough to deal with such ultra-expensive therapies. While the Centers for Medicare & Medicaid Services has agreed to pay 200,000 for the drugs, additional in-patient costs result in around a $hundreds of thousands of dollars loss per patient for hospitals. Further complexities are added by the fact each US state has multiple Medicaid authorities, prompting a call for an overhaul to the reimbursement system in favour of a sustainable model.
US hospitals using innovative CAR-T treatments are facing additional costs because the health care payment system hasn't evolved fast enough to deal with such ultra-expensive therapies. While the Centers for Medicare & Medicaid Services has agreed to pay hundreds of thousands of dollars for the drugs, additional in-patient costs result in around a $200,000 loss per patient for hospitals. Further complexities are added by the fact each US state has multiple Medicaid authorities, prompting a call for an overhaul to the reimbursement system in favour of a sustainable model.