Cell and gene therapy treatments are a groundbreaking frontier in medical treatment, promising not just to alleviate symptoms, but potentially cure life-threatening diseases. These therapies work by altering the genetic material inside a patient’s cells, offering solutions to genetic disorders and diseases previously deemed untreatable.

How Cell and Gene Therapy Works

At its core, cell and gene therapies involve replacing, inactivating, or introducing genes into cells to treat a disease. This can be done either inside the body (in vivo) or outside (ex vivo), depending on the disease and the type of therapy. These treatments have the potential to transform care for conditions like certain cancers, inherited metabolic disorders, and rare diseases.¹

Navigating High Costs and Complex Logistics

Although promising for patients, cell and gene therapies can come with very high price tags and complex delivery challenges.

“Cell and gene therapies are groundbreaking treatments that have the potential to reduce or cure life-threatening diseases. They can make a real difference to patients and their families,” said Brad Nieland, Berkley Accident and Health President and CEO.

“However, they can also come with extraordinarily high costs. The latest gene therapies to enter the market have estimated costs of $2 million to $4 million,” explained Nieland. “That’s why we’re excited to proactively help customers navigate the complexities of cell and gene therapies and lower the financial burden. It’s part of our ongoing commitment to making self-funding more accessible and predictable.”

This is where insurance solutions like Berkley Accident and Health’s Employer Stop Loss insurance play a crucial role. These solutions help self-funded employers mitigate the financial risks associated with large medical claims by providing benefits like the Cell and Gene Therapy Step-Down Deductible. This benefit lowers the Stop Loss Specific deductible for eligible claims when using an approved Center of Excellence network, making these advanced treatments more accessible and affordable to employers and their employees.

Looking to the Future

As we continue to witness more medical advances, the role of comprehensive insurance solutions becomes increasingly important. By integrating educational support and cost-containment services, insurers like Berkley Accident and Health not only provide financial protection, but also help employers to navigate the complexities of today’s health care system.

To learn more about how Berkley Accident and Health is making cell and gene therapies more accessible for our policyholders, get in touch with an expert near you.

¹ American Society of Gene + Cell Therapy, 2022, Gene therapy basics, https://patienteducation.asgct.org/gene-therapy-101/gene-therapy-basics?_gl=1*eoyj3z*_ga*ODE4MzIyMjAyLjE3MTYzOTgyNjI.*_ga_Q37QKR6TCJ*MTcxNjM5ODI2Mi4xLjEuMTcxNjM5ODM5NS4wLjAuMA..&_ga=2.253962504.1405194210.1716398262-818322202.1716398262

Stop Loss policies are underwritten by Berkley Life and Health Insurance Company and/or StarNet Insurance Company, both member companies of W. R. Berkley Corporation and rated A+ (Superior) by A.M. Best. Not all products and services may be available in all jurisdictions, and the coverage provided is subject to the actual terms and conditions of the policies issued.  Payment of claims under any insurance policy issued shall only be made in full compliance with all United States economic or trade and sanction laws or regulation, including, but not limited to, sanctions, laws and regulations administered and enforced by the U.S. Treasury Department’s Office of Foreign Assets Control (“OFAC”).

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