The transformative potential of cell and gene therapies is being hampered by significant access barriers, particularly affecting underserved populations, according to McKesson's comprehensive 2024 Cell and Gene Therapy Report. While these revolutionary treatments continue to exceed clinical benchmarks, their delivery remains largely confined to academic medical centers in metropolitan areas.
"Cell and gene therapy is such an exciting space. The science has outperformed the benchmarks in every area that cell and gene therapy has explored," states Joe DePinto, MBA, head of cell, gene, and advanced therapies at McKesson Pharmaceutical Solutions and Services. "The commercial success has not caught up at this point, because it is still very much a nascent space."
Geographic and Logistical Challenges
The report reveals significant "treatment deserts" across the United States, with many patients required to travel more than 50 miles to receive care. This distance creates substantial logistical and financial burdens, particularly for socioeconomically disadvantaged populations who must arrange extended stays with caregivers near treatment centers.
Strong Clinical Support Despite Access Issues
Survey results from 124 hematologists/oncologists demonstrate overwhelming support for these therapies:
- 99% consider them among the most innovative medical interventions
- 94% report significant positive impact on patient quality of life
- Growing evidence supports their use in earlier treatment lines
Financial Barriers and Payment Innovation
The current healthcare system faces challenges in accommodating the unique cost structure of cell and gene therapies. These treatments typically require substantial upfront payments while delivering benefits over extended periods, creating a misalignment with traditional annual insurance models.
"The payer system in the US really is not set up to absorb that, because they look at 1 year at a time, and these costs tend to be a bit more costly than the available products on the market," DePinto explains. Industry experts advocate for innovative payment solutions, including:
- Value-based payment models
- Outcomes-based arrangements
- Annuity-type payments
- Treatment warranties
Awareness and Education Gaps
Patient awareness remains a significant challenge, with 47% of oncologists reporting that patients rarely or never know about cell and gene therapy options. This knowledge gap represents a crucial barrier to treatment access and adoption.
Future Developments and Expansion
The field is poised for significant expansion beyond academic centers into community hospitals and clinics. This growth is driven by:
- Increasing treatment demand exceeding academic center capacity
- Research progression into earlier disease stages
- Expansion into new therapeutic areas including autoimmune and neurological conditions
- Need for standardized delivery processes to serve larger patient populations
Moving Toward Solutions
Addressing these challenges requires a multi-faceted approach focusing on:
- Expanding authorized treatment centers
- Developing standardized delivery processes
- Implementing innovative payment models
- Increasing patient and provider education
- Improving manufacturing and operational efficiency
As the field matures, stakeholders across healthcare must collaborate to ensure these breakthrough therapies reach all eligible patients, regardless of geographic or socioeconomic status.
