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Gene Therapy Access: The Pharmacy’s Role in the $3 Million Prescription

  • 72 minutes
  • 38 slides
What we'll cover
  • 0:00 Why Access Breaks Differently
  • 8:00 The Gene Therapy Access Map
  • 18:00 Coverage, Coding, And Payment Logic
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What you'll take away

Practical shifts you can apply this week

  • Identify the pharmacy-controlled failure points that delay gene therapy initiati

    Spot the handoffs and assumptions that quietly stall treatment before product ever moves.

  • Compare distribution, reimbursement, and site-of-care models for ultra-high-cost

    See how payment pathway and care setting choices shape speed, risk, and who owns what.

  • Evaluate financial, operational, and clinical readiness before product is releas

    Use a practical readiness lens before shipment, not after a preventable problem shows up.

  • Design a cross-functional pharmacy workflow for access, dispensing, and post-inf

    Build checkpoints, stop points, and shared documentation across pharmacy, finance, and site teams.

  • Defend the pharmacy’s role in reducing time-to-treatment and avoidable financial

    Leave with a clear case for why pharmacy is the operational hinge in one-time therapy access.

Agenda

What we'll cover

  1. 0:00

    Why Access Breaks Differently

    Why one missed step can derail a one-time therapy, with examples from Zolgensma and real referral delays.

  2. 8:00

    The Gene Therapy Access Map

    Walk the journey from referral to administration and see where delays tend to hide.

  3. 18:00

    Coverage, Coding, And Payment Logic

    Compare medical vs pharmacy benefit, buy-and-bill, white bagging, PA logic, and reimbursement timing.

  4. 30:00

    Financial Risk Before Shipment

    Review patient liability, assistance, denials, spoilage, replacement terms, and cash-flow exposure.

  5. 40:00

    Operational Readiness At Site

    Cover certification, cold chain, chain of identity, labs, scheduling, and product arrival coordination.

  6. 49:00

    Pharmacy Workflow That Holds

    Outline the minimum workflow, escalation triggers, and shared documentation that keeps assumptions in check.

  7. 56:00

    Metrics, Recap, And Q&A

    Track preventable delay, financial exposure, and handoff quality, then map one high-risk workflow in your organization.

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