Health

Maryland Strengthens Access for Lifesaving Sickle Cell Treatments

By Patrick Herron
Maryland has joined the federal Cell and Gene Therapy Access Model to improve affordability and access to costly sickle cell treatments for Medicaid participants, aiming to expand patient care while reducing healthcare costs.

Per the Maryland Department of Health: “Maryland Medicaid participants can now more easily access cell and gene therapies for sickle cell disease under Maryland’s participation in the federal Cell and Gene Therapy (CGT) Access Model. Participation in the CGT Access Model ensures better pricing in Maryland for high-cost medications, which helps to reduce costs and strengthen support services for patients and families who need access to these life-changing treatments.

“Maryland is committed to providing innovative and accessible health solutions designed specifically for our residents,” said Maryland Department of Health Secretary Dr. Meena Seshamani. “By signing on to the CGT Access Model, we are expanding the state’s ability to provide costly, life-saving treatments that will allow Medicaid participants access to the care they need.”

The CGT Access Model, administered by the Centers for Medicare & Medicaid Services (CMS), is a new federal initiative that tests whether CMS-led outcomes-based agreements (OBAs) increase Medicaid beneficiaries’ ability to access innovative treatments, improve their health outcomes, and reduce healthcare costs and burden to state Medicaid programs.

Under the model, CMS negotiates outcomes-based supplemental rebate agreements with pharmaceutical manufacturers for participating Medicaid programs. The two sickle cell therapies currently available are already FDA-approved for eligible patients. Participation in the model is estimated to save the State of Maryland more than $1 million per patient.

While Maryland Medicaid participants may access cell and gene therapies through standard coverage, beginning Jan. 1, 2026, the state will start receiving the enhanced rebates and financial protections provided under the CGT Access Model for Maryland Medicaid participants who are eligible for either of the two therapies, a requirement under the model.The Model initially focuses on sickle cell disease, a life-threatening condition that affects about 100,000 people nationwide and disproportionately impacts Black communities. While new cell and gene therapies have shown promise, their high cost has made access difficult. Maryland’s participation in this Model aims to make these groundbreaking treatments more affordable and accessible for the people who need them.

“These therapies mark a turning point in how we treat rare and life-threatening diseases like sickle cell,” said Chief Medical Officer Dr. Djinge Lindsay. “For decades, patients faced limited options and lifelong complications. This Model allows us to provide coverage for groundbreaking treatments based on results–not just costs–so more Marylanders can benefit from real medical breakthroughs.”

Approximately 3,000 Maryland Medicaid participants have sickle cell disease, though some may not meet the clinical criteria to qualify for either of the cell and gene therapies. The therapies currently available through the CGT Access Model are through two authorized treatment centers within Maryland Medicaid’s provider network, the University of Maryland Medical Center in Baltimore City and Children’s National Hospital in Washington, D.C.Each September, Sickle Cell Awareness Month shines a light on the challenges faced by those living with Sickle Cell Disease and celebrates advancements in care. By joining the CGT Access Model, Maryland is taking an important step toward ensuring that residents living with this painful, life-threatening disease can access the most advanced treatments available.

For more information on sickle cell disease resources in Maryland, visit the Maryland Sickle Cell Disease Association.”

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