Milliman Reviews a Decade of Cell and Gene Therapy Cost Forecasting for Payers

Milliman examines ten years of actual cell and gene therapy (CGT) market experience versus early payer expectations, finding that the anticipated wave of approvals and utilization never materialized as predicted, though costs remain high and unpredictable. The paper proposes forecasting methods using manufacturer revenue data rather than claims alone, and offers case studies on Zolgensma and Elevidys to illustrate volatility in uptake—insights relevant to any payer, including Medicaid MCOs, managing specialty drug risk and benefit design.</summary> </invoke>

Pharmacy · Managed Care

This is outside commentary from Milliman, not part of Medicaid Monitor's independently scored news coverage.