Achieving reimbursement for regenerative medicine products in the USA

Reduction of Activin A gives rise to comparable expression of key definitive endoderm and mature beta cell markers

Aim: Cell therapies for diabetes rely on differentiation of stem cells into insulin-producing cells, which is complex and expensive. Our goal was to evaluate production costs and test ways to reduce it. Methods: Cost of Goods (COGs) analysis for differentiation was completed and the effects of replacement or reduction of the most expensive item was tested using qRT-PCR, immunohistochemistry, flow cytometry along with glucose-stimulated insulin release. Results: Activin A (AA) was responsible for significant cost. Replacement with small molecules failed to form definitive endoderm (DE). Reducing AA by 50% did not negatively affect expression of beta cell markers. Conclusion: Reduction of AA concentration is feasible without adversely affecting DE and islet-like cell differentiation, leading to significant cost savings in manufacturing.

Challenges in the market access of regenerative medicines, and implications for manufacturers and decision-makers: a systematic review

Aim: Regenerative medicines (RMs) are expected to transform the treatment paradigm of rare, life-threatening diseases, while substantial challenges impede its market access. This study aimed to present these challenges. Materials & methods: Publications identified in the Medline and Embase databases until December 2020 were included. Results: Uncertainties around the relative effectiveness and long-term benefits of RMs are most scrutinized. A new reference case for RMs is questionable, but examining impacts of study perspective, time horizon, discount rate and extrapolation methods on estimates is advised. Establishing reasonable prices of RMs requires increased transparency in the development costs and better values measurements. Outcome-based payments require considerable investments and potential legislative adjustments. Conclusion: Greater flexibility for health technology assessment and economic analyses of RMs is necessary. This comprehensive review may prompt more multi-stakeholder conversations to discuss the optimized strategy for value assessment, pricing and payment in order to accelerate the market access of RMs.

Reimbursement and pricing of regenerative medicine in South Korea: key factors for achieving reimbursement

In the South Korean health technology assessment system, prices of alternative medicines, incremental cost-effectiveness ratios in pharmaco-economic evaluations and patient access improvement systems such as risk-sharing agreements are the most important factors concerning the reimbursement of regenerative medicine (RM). Research and development companies in RM should review the key features of these medicines throughout the product development cycle to increase the probability of successful reimbursement. In addition, the South Korean government should take steps to improve the system to reflect the unique characteristics and value of RM in the reimbursement and pricing policy, to revitalize research and development, and increase patient access.

Insurance systems and reimbursement concerning research and development of regenerative medicine in Japan

In Japan, the Act on the Safety of Regenerative Medicine and the Pharmaceuticals, Medical Devices and Other Therapeutic Products Act were enacted in November 2014, creating a new framework for clinical research and products related to regenerative medicine. Together with these regulatory frameworks, new insurance procedures were created for handling regenerative medicine in Japan. For developing regenerative medicine in Japan, understanding medical insurance greatly influences funding and venture success, particularly in the stages between clinical research and market launch. The study aimed to identify the issues and examples surrounding Japan's present medical insurance system, especially for regenerative medicine. We believe that building stronger insurance systems for regenerative medicine is essential for internationally aligning and harmonizing the progress of regenerative medicine.

The UK relative to other single payer-dominated healthcare markets for regenerative medicine therapies

The UK has for many years been considered by businesses, including those based in the UK, as at best a second market for the launch of innovative medical technology products. Historically, this has been attributed to the slow pace of adoption in its National Health Service (NHS). The NHS is perceived to be subject to cost containment, high levels of fragmentation and a lack of strategic incentives to resolve its key failings as a market. Canada and Sweden offer examples of different operating models of healthcare delivery in a single payer-dominated market, and as a consequence, have evolved with different market characteristics. Together, these economies represent an important subsection of healthcare markets that are predominantly publically funded. This report examines the barriers to market entry for regenerative medicine products in these economies and attempts to evaluate the upcoming UK healthcare reforms in terms of impact on the regenerative medicine industry sector.

Progress in the tissue engineering and stem cell industry "are we there yet?"

This report presents a detailed update to our 2008 publication on the tissue engineering (TE) and stem cell industry. Data are reported through mid 2011 showing an almost three-fold growth in commercial sales over the past 4 years. In addition, the number of companies selling products or offering services has increased over two-fold to 106, and they are generating a remarkable $3.5 billion in sales. Overall, the TE and stem cell sector is spending $3.6 billion and employing almost 14,000 employees. These data suggest the TE and stem cell industry has stabilized and is on a path pointing toward continued success.

Regenerative medicine, resource and regulation: lessons learned from the remedi project

The successful commercialization of regenerative medicine products provides a unique challenge to the manufacturer owing to a lack of suitable investment/business models and a constantly evolving regulatory framework. The resultant slow translation of scientific discovery into safe and clinically efficacious therapies is preventing many potential products from reaching the market. This is despite of the need for new therapies that may reduce the burden on the world's healthcare systems and address the desperate need for replacement tissues and organs. The collaborative Engineering and Physical Sciences Research Council (EPSRC)-funded remedi project was devised to take a holistic but manufacturing-led approach to the challenge of translational regenerative medicine in the UK. Through strategic collaborations and discussions with industry and other academic partners, many of the positive and negative issues surrounding business and regulatory success have been documented to provide a remedi-led perspective on the management of risk in business and the elucidation of the regulatory pathways, and how the two are inherently linked. This article represents the findings from these discussions with key stakeholders and the research into best business and regulatory practices.

Founder's award to Antonios G. Mikos, Ph.D., 2011 Society for Biomaterials annual meeting and exposition, Orlando, Florida, April 13-16, 2011: Bones to biomaterials and back again--20 years of taking cues from nature to engineer synthetic polymer scaffolds

For biomaterials scientists focusing on tissue engineering applications, the gold standard material is healthy, autologous tissue. Ideal material properties and construct design parameters are thus both obvious and often times unachievable; additional considerations such as construct delivery and the underlying pathology necessitating new tissue yield additional design challenges with solutions that are not evident in nature. For the past nearly two decades, our laboratory and collaborators have aimed to develop both new biomaterials and a better understanding of the complex interplay between material and host tissue to facilitate bone and cartilage regeneration. Various approaches have ranged from mimicking native tissue material properties and architecture to developing systems for bioactive molecule delivery as soluble factors or bound directly to the biomaterial substrate. Such technologies have allowed others and us to design synthetic biomaterials incorporating increasing levels of complexity found in native tissues with promising advances made toward translational success. Recent work focuses on translation of these technologies in specific clinical situations through the use of adjunctive biomaterials designed to address existing pathologies or guide host-material integration.