Quantile Health is solving the problem of patient access to transformative treatments with an innovative access model. Today, we are proud to announce that we’ve raised $6 million in funding led by Munich Re Ventures with support from First Round Capital and Correlation Ventures to expand our payer partnerships and manufacturer network.
Waves of gene therapies are reaching the market, but the payment solution is not yet in place
Gene therapies represent a promising future of treatments — but at a staggering cost. The cost of a single gene therapy can exceed $3 million - equivalent to the entire annual health insurance budget for a smaller, self-insured employer plan. With over 120 million Americans receiving health insurance under employers’ self-insured plans, this potential budget risk has caused nearly a third of all self-insured plans to drop coverage for gene therapies1. Even more are considering dropping coverage in the coming years.
The fee-for-service model, which is simply not working for gene therapies, is a market inefficiency with devastating consequences. In human terms, this means children with fatal conditions and patients with excruciating pain are denied life-saving treatments. The approval of Casgevy and Lyfgenia for sickle cell disease this past December makes the need for a new payment model even more pressing.
Introducing subscription-based access to gene therapies
With backgrounds in financial engineering and insurance, our team intimately understands the complex issues at play, and has developed a unique risk transfer platform for US payers and gene therapy manufacturers. Instead of paying for each treatment, payers and employers of all sizes can subscribe to the right to access treatments directly from manufacturers. The payer pays a fixed cost reflecting the underlying risk of their population without having financial exposure to catastrophic tail risk scenarios.
For example, instead of a single patient’s gene therapy costing over $3 million, the average self-insured employer could subscribe all of its employees to the gene therapy access for less than $1,000 a year. This aligns incentives and represents a major improvement for everyone: pharmaceuticals get increased coverage for their therapies, payers mitigate financial risks at lower cost, and — most importantly — patients get unfettered access to lifesaving treatments.
New funding to help us make transformative medicine accessible to every patient
We are honored to announce that we have raised $6 million in funding and are working with the teams from Munich Re Ventures, First Round Capital, and Correlation Ventures. We’ve partnered with some of the most forward thinking drug innovators, and this funding will allow us to build out broader partnerships toward our mission of making transformative medicine accessible to every patient. If you’re interested in joining our cause, please contact us at info@quantilehealth.com.
It’s not every day in healthcare that we see a platform that truly aligns incentives across the ecosystem,” shares Sidra Ahmed, Investment Director at Munich Re Ventures. “We are excited to partner with Quantile Health in support of their vision of building an innovative model addressing the cell and gene therapy financing conundrum.
We're excited to be partnering with Munich Re Ventures and our other Seed investors to implement a sustainable payment model that makes gene and cell therapies accessible to the broadest set of patients as soon as possible. Investors can do well by doing good, and Quantile now has the funding to do it for the many life-saving gene and cell therapies under development.
1 Erin Lopata et al, "Meeting the affordability challenges posed by orphan drugs: a survey of payers, providers, and employers." Journal of Managed Care & Specialty Pharmacy 27, no. 6 (2021): 706-713.