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At a glance
WHAT IT’S REALLY ABOUT
Julie Yoo on Making Miracle Drugs Affordable Without Breaking Healthcare
- Julie Yoo argues that GLP-1s and curative cell and gene therapies are miracle drugs, but the current insurance system cannot bear their costs or properly value them.
- GLP-1s began as type 2 diabetes treatments and now reach obesity, with possible cardiovascular benefits, yet only about a quarter of employer plans cover them and they cost roughly $1,000 a month.
- Cell and gene therapies can cost $2 to $3 million as a one-time fee and require highly complex logistics, so short employee tenure and a misaligned payer structure discourage insurers from paying upfront.
- Startups are already building pieces of the solution in manufacturing, clinical operations, data infrastructure, and financing, but the big opportunity is a holistic solution that convenes payers, providers, manufacturers, and patients.
- Yoo expects the FDA and CMS to eventually play critical roles, though an election year may slow policy, so she expects a mix of top-down regulation and bottom-up innovation.
IDEAS WORTH REMEMBERING
5 ideasGLP-1s are valued for more than weight loss
Yoo says the hormone-based drugs treat type 2 diabetes and suppress appetite, and recent studies suggest significant cardiovascular benefits that matter to insurers.
Coverage of GLP-1s is still immature
A study Yoo cites found about 3.6 million GLP-1 prescription claims in 2022, and only roughly 25 percent of employer-sponsored plans cover them, so access is far below the eligible population.
Insurance incentives clash with curative therapies
A $2 to $3 million upfront cost is hard for an employer to justify when the employee may leave the plan in two or three years, before the benefits accrue.
Financing innovation is needed to spread risk
Yoo says new underwriting mechanisms could let each payer cover only its fair share while a patient is on its plan, or create a portable product that follows the person through life.
Cell and gene therapies could break the delivery system
They involve removing cells, manufacturing and reprogramming them, infusing them in certified hospitals, and weeks of monitoring, which the traditional biopharma value chain is not built to handle.
WORDS WORTH SAVING
5 quotesour current healthcare insurance system is just not set up to bear the cost of these therapies or to accurately gauge their value, given that some are curative
— Julie Yoo
what incentive do I have to pay, you know, this upfront fee for something that will benefit this person over the entirety of their life, but that person is gonna leave my insurance plan in maybe two or three years?
— Julie Yoo
imagine as a product manager if you just never-- if you didn't have any closed loop of data on how your product was being used in the real world or any feedback from your end users. That is unfortunately, like, the state of affairs for many drugs that we have on the market today
— Julie Yoo
our, our current system just is not designed at all to be able to handle the adoption and absorption and access to these kinds of therapies today.
— Julie Yoo
as most things in healthcare, it'll be a combination of both sort of top-down regulation and policy combined with, uh, some of the bottoms-up activity that we already see starting to happen from those who are just feeling the pain today and just need to kick into action.
— Julie Yoo
High quality AI-generated summary created from speaker-labeled transcript.
