Improving Access, Transparency, and Outcomes in Cell & Gene Therapy

In this interview, Joe DePinto, head of Cell, Gene, and Advanced Therapies at McKesson, discusses the launch of InspiroCare—a cell- and gene-specific hub designed to remove barriers to patient access, streamline coordination across stakeholders, and drive data transparency to support innovative payment models and improved patient outcomes.

Joe DePinto: My name is Joe DePinto. I'm the head of Cell, Gene, and Advanced Therapies at McKesson. I've been in this role for 3 years, building out the cell and gene vertical called InspiroGene that meets the needs of the cell and gene ecosystem and the value chain for manufacturers, payers, and providers.

How does InspiroCare address some of the most common barriers to timely access for patients undergoing cell and gene therapy, and what measurable outcomes are you tracking to demonstrate improved patient journeys?

DePinto: InspiroGene has had its entire strategy driven by removing barriers in patient access for cell and gene therapies commercially.

We've systematically looked at what those barriers are and how to ensure that patients have greater access by working with our partners—the manufacturers of these products, the biopharma companies, the payers, as well as the health care professionals. In doing so, one of the high needs [we found] was the hub space and patient access from the hub space—helping patients navigate the complexities of the value chain and looking at that complexity in a way where a hub could help the patients and their caregivers navigate the whole journey, from diagnosis, all the way to the pre-treatment requirements, the treatment requirements, as well as long-term follow-up.

We launched InspiroCare recently, which is our cell- and gene-specific hub. That hub is focused on the needs of the cell and gene therapy patients and their caregivers. We focus this differently than we would just a regular hub. It's more case management, very specific around looking at coordination of activity and making sure that we're helping the patient and the caregiver navigate the experience. It's very important to all the key stakeholders, the manufacturers, the providers who give care, and the payers as well.

InspiroCare was built from the bottom up for cell and gene patients. It's very modular because all cell and gene therapies don't act the same. They need to be highly configurable in the journey to be able to match up to what the patient, the provider, and the manufacturer's experience is, as well as the payer.

That's what we set out to do. That's what we're excited about launching in InspiroCare. We believe it will provide significant value to the patients and their caregivers, the manufacturers, the biopharma companies, as well as the providers, as patients navigate the complexity of the delivery of cell and gene therapies commercially.

InspiroCare is “integrated by design” within the cell and gene therapy (CGT) workflow — can you explain how this integration helps streamline coordination with payers, specialty pharmacies, and providers who may all have different systems and requirements?

DePinto: InspiroCare is integrated within the cell and gene ecosystem. It works, specifically, through a combination of a technology platform and an operating model. The tech platform acts as the backbone to help guide the patient and the caregivers through the complexity of the operational journey, as well as the clinical and reimbursement journey.

However, the operating model of case management really helps manage, day to day, the process of delivering cell and gene therapies. InspiroCare fits nicely within Biologics, which is our specialty pharmacy that's focused on delivering of cell and gene therapy and rare diseases. It's a great fit.

The integration of the two is great because of the strong provider network at Biologics, as well as the strong payer network at Biologics. We have a lot of experience in complex medical benefit. InspiroCare will be managing that patient through the medical benefit journey. This includes everything from benefit verification, benefit approval, prior authorizations, and assuring that the payer is on board and coordinated with the delivery of care at a specific site of care, and then coordinating with the manufacturer to ensure that the product will be ready and delivered and manufactured.

Some of this stuff has a bit of a longer lead time than a typical product. Coordination, transparency, and assuring that there's strong communication will take a combination of a strong tech platform and a strong personnel operating model to be able to manage this for all the key stakeholders.

That integration is not only a technical integration; it's an operating model, technology, and ecosystem transparency goal that helps patients navigate what is not the easiest of processes to get these therapies.

With the modular approach where biopharma sponsors can scale services up or down, what types of services are most commonly requested, and how do you see this adaptability influencing payer negotiations or market access strategies?

DePinto: I think that hubs in cell and gene therapy have been on a bit of a journey. There was a period of time where all of the biopharma manufacturers wanted to own the relationship with the centers of excellence and the providers, as well as the payers, and built their own hubs internally.

Some of the smaller biotechs outsourced this hub activity because of affordability. Biopharma manufacturers, of course, want to delight their customers with their experience, but hubs are not really what they do. They bring groundbreaking therapeutics to the market. What spawned is a bit of a hybrid model where biopharma manufacturers will do certain components of the case management in the hub and then farm out other components to companies, like InspiroCare—whether that be travel and logistics, benefit verification, or additional work on looking at patient education and resources that are available for patients and their caregivers to take advantage of.

The model has morphed over the years, and we're seeing more and more demand for cell- and gene-specific hubs. There are a lot of hubs out there that do great work in high-volume, high-throughput, technology-driven settings, where they are working in very large therapeutic areas like diabetes or cardiovascular disease. [In these areas] it's high throughput, moving through the system efficiently, getting the work complete, and, with payer approval, patient's getting access. It typically moves quickly.

With cell and gene therapy, it's the opposite. It's more of a case management, individually bespoke byproduct type, looking at managing a complex product journey, patient journey, and reimbursement journey. You need a different type of expertise. That type of expertise is really important. Aligning with the payers, a hub like InspiroCare will be doing this work as the manufacturers set up their payer networks. It's important that there's a clear communication that companies like InspiroCare will be doing this work on behalf of the patients as they look to assure that benefits are validated and approved prior to moving forward with these products in the provider setting.

That's how all this comes together. It's been an evolution, and it continues to evolve. Where we sit with InspiroCare and InspiroGene as a whole, we're uniquely positioned to deliver this value, which is exciting. It's been a year plus in the building, and we're excited to launch it in the market.

InspiroCare emphasizes data transparency. Can you share how real-time insights are shared with stakeholders like payers and providers, and whether this data is being leveraged to support value-based agreements or outcomes-based contracting in cell and gene therapy?

DePinto: Technology and the operating model working together are really important to provide as much transparency to the entire cell and gene ecosystem as possible. You have a pre-treatment component, where there's a lot of understanding if benefits are verified and approved, diagnosis, and labs. Then there's during treatment, which involves navigating through the patient journey and the product journey to ensure treatment is delivered on time and in the right place. Then there's post-treatment with long-term follow-up. All have significant data components that need to be coordinated. The unique part of the InspiroCare hub is that we sit smack in the middle of this process, so we have unique insights and data that, as long as consented, could be shared appropriately to help understand the efficiency of the delivery and then, perhaps, outcomes can be derived by that.

Manufacturers, providers, and payers all see the criticality of innovative payment models moving forward. The payers and the providers have been pretty vocal in our research, saying that they believe this is a way to alleviate one of the barriers to care.

There have been some in the market. Again, the ability to clearly track and define what data requirements allow for value or not is an important component. How simple it is, how trackable it is, and how you can do it long-term from a longitudinal standpoint is really important. The position that InspiroCare hub sits in the value chain is that we're uniquely positioned to have good insights there.

I think that as this continues to evolve—innovative payment models and value-based care—that will be an area we'll continue to explore on how to provide that value to our manufacturer clients, our payers, as well as the providers who give these products.