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MAY 26, 2023

Stop-Loss Programs May Offset ‘Coming Tsunami’ of Gene Rx

By Karen Blum

SAN ANTONIO—In the era of increasingly high prices for some orphan drugs and for gene and cell therapies, health plans are turning to reinsurance and stop-loss programs to help reduce their risk, according to a presentation at AMCP 2023.

Reinsurance and stop-loss programs provide balance-sheet protection to payors by reimbursing catastrophic costs, said Rick Lassow, FSA, MAAA, the vice president of actuarial and underwriting for Summit Re, a managing general underwriter and