Aetna creates new gene therapy network

Print Friendly, PDF & Email

WOONSOCKET, R.I. — Aetna announced on Wednesday the launch of its designated Gene-based, Cellular, and Other Innovative Therapies (GCIT) network. This network is designed to enable members’ access to new therapies that treat and potentially cure rare genetic diseases, while helping to manage the high cost of these therapies. Aetna’s national GCIT network includes access to more than 75 designated GCIT service providers that have demonstrated quality and value in the delivery of GCIT services.

“We’re creating a differentiated provider network that our customers can experience as being caring, connected and convenient,” said Richard Gentleman, executive director, National Partner Strategy, Aetna. “Our multi-pronged approach encompasses safety, member access to cutting-edge therapies, and cost management to support the medical and economic needs of our members and customers. It also paves the way for future FDA-approved gene therapies to be added quickly and cost-effectively so that we can help more people achieve their best health.”

Beginning January 1, 2022, Aetna’s designated GCIT network will provide three gene therapy services, including Luxturna, Spinraza and Zolgensma for the treatment of inherited retinal disease and spinal muscular atrophy. The GCIT network is included as a standard medical benefit in all Aetna fully insured plans and is also available to self-insured plans.

Through Aetna’s designated GCIT network, members and customers benefit from:

  • A comprehensive strategy to support access and manage the cost of current and future FDA-approved gene therapies. 

  • A network of more than 75 designated GCIT service providers that have demonstrated quality and value in the delivery of GCIT services. 

  • A dedicated clinical team to guide members and providers through the health care process, including case management, where applicable, and travel and lodging support for members who need to travel 100 miles or more for care.

The GCIT network also offers a financial protection program for CVS Caremark clients and Aetna plan sponsors who do not have traditional stop-loss.

“Gene therapy is poised for significant growth in the coming years, and the promise of durable improvement for patients with challenging diseases is exciting,” said Joanne Armstrong, M.D., MPH, Chief Medical Officer, Women’s Health and Genomics at CVS Health. “Yet, high costs associated with these therapies continue to pose a significant challenge. It is therefore vital that they are delivered by highly-specialized providers in an environment that can provide the patient receiving the therapy a high potential of a successful outcome.”

By utilizing a GCIT-designated provider, members will be receiving treatment from a provider that has demonstrated experience in providing these unique services. Providers in the GCIT network must meet manufacturer-specific guidelines and Aetna cost and credentialing standards.

Since 2018, Aetna has managed Chimeric Antigen Receptor T-cell (CAR-T) services, an early genetically engineered therapy, through a long-standing transplant network department, the National Medical Excellence Program.  An additional 120 bone marrow/stem cell transplant facilities that have been designated to perform CAR-T services are located here.

A list of GCIT-approved network facilities can be found here. To learn about additional solutions CVS Health is developing to help mitigate the financial impact for our customers and their plan members, please read our white paper on gene therapy.



Comments are closed.