# The value-based price of transformative gene therapy for sickle cell disease: a modeling analysis

## TL;DR

The paper estimates the value-based price of gene therapy for sickle cell disease in different countries to ensure affordability and accessibility.

## Contribution

The study introduces a novel cost-utility model to determine country-specific value-based prices for gene therapy in sickle cell disease.

## Key findings

- Hypothetical gene therapy reduces SCD symptoms and disability-adjusted life-years over time.
- Value-based prices for gene therapy vary widely, from $3.6 million in the US to $700 in Uganda.
- The model suggests tailored pricing is essential for global accessibility of gene therapy.

## Abstract

Sickle cell disease (SCD) is an inherited, progressively debilitating blood disorder. Emerging gene therapies (GTx) may lead to a complete remission, the benefits of such can only be realized if GTx is affordable and accessible in the low-and middle-income countries (LMIC) with the greatest SCD burden. To estimate the health impacts and country-specific value-based prices (VBP) of a future gene therapy for SCD using a cost-utility model framework. We developed a lifetime Markov model to compare the costs and health outcomes of GTx versus standard of care for SCD. We modeled populations in seven LMICs and six high-income countries (HICs) estimating lifetime costs and disability-adjusted life-years (DALYs) in comparison to estimates of a country’s cost-effectiveness threshold. Each country’s unique VBP for GTx was calculated via threshold analysis. Relative to SOC treatment alone, we found that hypothetical GTx reduced the number of people symptomatic with SCD over time leading to fewer DALYs. Across countries, VBPs ranged from $3.6 million (US) to $700 (Uganda). Our results indicate a wide range of GTx prices are required if it is to be made widely available and may inform burden and affordability for ‘target product profiles’ of GTx in SCD.