Carbon Stop Loss Solutions

???THE LATEST: Ryoncil (remestemcel-L) offers a crucial option for pediatric patients facing steroid-refractory acute graft-versus-host disease (GVHD), a condition with high morbidity and mortality following allogeneic stem cell transplants. Acute GVHD can arise within 2-6 weeks post-transplant—meaning treatment often begins while the patient is already hospitalized—prolonging length of stay and driving significant cost impact. ? Mesoblast has set the MFG invoice price at $194K per infusion, totaling $1.55M for an initial course and up to $2.3M for extended treatment. These costs come on top of the expense of the transplant itself. As commercial rollout continues across top transplant centers, Carbon will work with a prospective approach to optimize contracting and help clients navigate this evolving exposure.

Neurotech Pharmaceuticals gets the FDA green light for Encelto, (revakinagene taroretcel), the first-ever allogeneic cell therapy for idiopathic macular telangiectasia type 2 (MacTel). ? Encelto takes the form of encapsulated engineered human epithelial cells in a cylindrical membrane (ECT), delivered by surgical intravitreal implantation, that continuously produces and releases ciliary neurotrophic factor (CNTF, a cytokine known to have a neuroprotective effect on retinal degeneration), into the retina and is designed to prevent photoreceptor cells from degenerating. ? MacTel is a bilateral retinal disease that leads to a gradual loss of central vision. Most MacTel patients are diagnosed in their 40s and 50s and the disease typically affects both eyes. In the type 2 form, tiny blood vessels around the fovea become abnormal and leak fluid, causing the macula to swell or thicken and photoreceptor cells to die off. To date, there has been no effective treatments or cure. MacTel is estimated to affect around one in every 1,000 people in the U.S.? ? Neurotech has not revealed pricing yet and expects U.S. availability in June 2025. Optimal contract is key to managing this evolving exposure. Carbon provides specialty financial and clinical resources needed for your protection. Contact Carbon Stop Loss Solutions to learn how. https://lnkd.in/db7Ga9s8 ?

Jakki Lynch, RN, CCM, CMAS, CCFA, Carbon's Director of Cost Containment, shared her insights regarding managing the growth of gene therapies in this month’s issue of The Self Insurer from Self-Insurance Institute of America ?? Read the full story here:?https://lnkd.in/eC4rWFPS #strongerbydesign?#theselfInsurer?#managedcare?#employerstoploss?#stoploss #celltherapy #genetherapy

We're excited to share the launch of our new website at carbonstoploss.com! ?? Take a spin and check out our robust employer stop loss and managed care?solutions that are stronger by design: https://lnkd.in/eDcDw8NB #strongerbydesign #employerstoploss #medicalstoploss #managedcare

The Happening: Mesoblast just announced?that the FDA has approved Ryoncil (remestemcel-L), an off the shelf allogeneic bone marrow-derived mesenchymal stromal cell (MSC) therapy indicated for the treatment of steroid-refractory acute graft versus host disease (SR-aGvHD) in pediatric patients 2 months of age?and up to adolescents and teenagers. 10,000 individuals in the US undergo an allogeneic bone marrow transplant annually, of whom 1,500 are pediatric patients. Nearly 50% of these patients develop graft versus host disease and about half do not respond to steroids, the current front-line therapy.? The mesenchymal lineage cell therapy technology platform is designed to respond to severe inflammation with the release of anti-inflammatory factors. These factors counter and modulate multiple effector immune system arms, leading to a reduction in the damaging inflammatory process. Mesoblast is working to obtain approval on?expanding the indications for Ryoncil in both children and adults with inflammatory conditions. Per Mesoblast, the therapy will be available at hospitals and transplant centers with pricing (comparable to other cell therapies) and availability forthcoming. Carbon brings creative solutions to assist in managing the analytics and reconciling the economics with our clients for this evolving risk. Contact us to learn how we do this. https://lnkd.in/dyqSzrP6

Breaking New Ground: On November 13th, the FDA approved PTC Therapeutics’ gene therapy Kebilidi??(eladocagene exuparvovec), for the treatment of children and adults with aromatic L-amino acid decarboxylase (AADC) deficiency. AADC deficiency is a fatal, extremely rare genetic disorder that typically causes severe disability and suffering from the first months of life, leading to decreased muscle tone, movement disorders, and disruption of the autonomic nervous system with only around?350 cases reported in the literature. The indication covers the full spectrum of disease severity, and the approval constitutes the first gene therapy for direct administration to the brain in the US. Kebilidi ??is delivered to the putamen via a 1-time treatment with a minimally invasive stereotactic neurosurgical procedure and provides a functional copy of DDC, the disease-targeted gene.?It uses a technology developed by ClearPoint Neuro (SmartFlow Neuro Cannula) for infusion into the brain performed by a qualified neurosurgeon in centers specialized in stereotactic neurosurgery. Patients will need to stay in or near the hospital for a few days to monitor recovery and check for any side effects from the surgery or the anesthesia. PTC has not yet disclosed the US list price - In the UK, the therapy has a listed price of about ￡3 million ($3.8 million) not including administration charges. Payers need to explore affordable solutions. Carbon provides specialty financial and clinical resources needed to assess and manage this novel exposure. Contact us to learn how. https://lnkd.in/gdtWR535

Impressive News:?FDA granted approval to AUCATZYL? (obecabtagene autoleucel) by Autolus Therapeutics, marking it as the second ??????-?? ?????????????? on the market for adults with relapsed or refractory B-cell precursor acute lymphoblastic leukemia (r/r ALL), after Tecartus (2021). Both therapies are indicated as third-line treatments.? Adult ALL is an extremely aggressive cancer, and there is a high unmet medical need that exists in the treatment of patients with this disease once they relapse, where historically they suffer from poor outcomes. AUCATZYL? is to be administered as split dose infusion on Day 1 and Day 10 (±2 days) based on bone marrow blast assessment and preceded by fludarabine and cyclophosphamide lymphodepleting chemotherapy. AUCATZYL? is the ?????????? CAR-T therapy approved by the FDA ?????????????? ?? ???????? (???????? ???????????????????? ?????? ???????????????????? ????????????????) ??????????????????????, signaling FDA confidence in its safety profile as it is?engineered to offer better safety and efficacy than its competition.?The price for AUCATZYL? is $525K (manufacturers invoice price for the infusion) not including administration costs. Having an optimal contract is key to managing this evolving exposure. Carbon?provides specialty financial and clinical resources needed for your protection. Contact Carbon Stop Loss Solutions to learn how. https://lnkd.in/g_-XdUjA

Chronic disease is no longer just an issue for the elderly—its growing prevalence among working-age Americans is forcing self-insured employers to rethink their cost management strategies. To combat rising healthcare expenses, Jakki L., Director of Cost Containment of Carbon Stop Loss Solutions (formerly Sequoia Reinsurance), emphasizes the need for a multifaceted approach that includes claim payment integrity, preventative care programs and strategic contracting in this month’s issue of The Self Insurer from Self-Insurance Institute of America, Inc. Read the full story here: https://lnkd.in/eD2edw88 ? #strongerbydesign ?#medicalbilling?#paymentintegrity #theselfInsurer #managedcare #employerstoploss #stoploss

Welcome to our new chapter! Introducing Carbon.... carbonstoploss.com

Welcome to our new chapter! Introducing Carbon.... carbonstoploss.com