Carbon Stop Loss Solutions

We're excited to share the launch of our new website at carbonstoploss.com! 💻 Take a spin and check out our robust employer stop loss and managed care solutions that are stronger by design: https://lnkd.in/eDcDw8NB #strongerbydesign #employerstoploss #medicalstoploss #managedcare

The Happening: Mesoblast just announced that the FDA has approved Ryoncil (remestemcel-L), an off the shelf allogeneic bone marrow-derived mesenchymal stromal cell (MSC) therapy indicated for the treatment of steroid-refractory acute graft versus host disease (SR-aGvHD) in pediatric patients 2 months of age and up to adolescents and teenagers. 10,000 individuals in the US undergo an allogeneic bone marrow transplant annually, of whom 1,500 are pediatric patients. Nearly 50% of these patients develop graft versus host disease and about half do not respond to steroids, the current front-line therapy.  The mesenchymal lineage cell therapy technology platform is designed to respond to severe inflammation with the release of anti-inflammatory factors. These factors counter and modulate multiple effector immune system arms, leading to a reduction in the damaging inflammatory process. Mesoblast is working to obtain approval on expanding the indications for Ryoncil in both children and adults with inflammatory conditions. Per Mesoblast, the therapy will be available at hospitals and transplant centers with pricing (comparable to other cell therapies) and availability forthcoming. Carbon brings creative solutions to assist in managing the analytics and reconciling the economics with our clients for this evolving risk. Contact us to learn how we do this. https://lnkd.in/dyqSzrP6

Breaking New Ground: On November 13th, the FDA approved PTC Therapeutics’ gene therapy Kebilidi™ (eladocagene exuparvovec), for the treatment of children and adults with aromatic L-amino acid decarboxylase (AADC) deficiency. AADC deficiency is a fatal, extremely rare genetic disorder that typically causes severe disability and suffering from the first months of life, leading to decreased muscle tone, movement disorders, and disruption of the autonomic nervous system with only around 350 cases reported in the literature. The indication covers the full spectrum of disease severity, and the approval constitutes the first gene therapy for direct administration to the brain in the US. Kebilidi ™ is delivered to the putamen via a 1-time treatment with a minimally invasive stereotactic neurosurgical procedure and provides a functional copy of DDC, the disease-targeted gene. It uses a technology developed by ClearPoint Neuro (SmartFlow Neuro Cannula) for infusion into the brain performed by a qualified neurosurgeon in centers specialized in stereotactic neurosurgery. Patients will need to stay in or near the hospital for a few days to monitor recovery and check for any side effects from the surgery or the anesthesia. PTC has not yet disclosed the US list price - In the UK, the therapy has a listed price of about £3 million ($3.8 million) not including administration charges. Payers need to explore affordable solutions. Carbon provides specialty financial and clinical resources needed to assess and manage this novel exposure. Contact us to learn how. https://lnkd.in/gdtWR535

Impressive News: FDA granted approval to AUCATZYL® (obecabtagene autoleucel) by Autolus Therapeutics, marking it as the second 𝗖𝗔𝗥-𝗧 𝘁𝗵𝗲𝗿𝗮𝗽𝘆 on the market for adults with relapsed or refractory B-cell precursor acute lymphoblastic leukemia (r/r ALL), after Tecartus (2021). Both therapies are indicated as third-line treatments.  Adult ALL is an extremely aggressive cancer, and there is a high unmet medical need that exists in the treatment of patients with this disease once they relapse, where historically they suffer from poor outcomes. AUCATZYL® is to be administered as split dose infusion on Day 1 and Day 10 (±2 days) based on bone marrow blast assessment and preceded by fludarabine and cyclophosphamide lymphodepleting chemotherapy. AUCATZYL® is the 𝗳𝗶𝗿𝘀𝘁 CAR-T therapy approved by the FDA 𝘄𝗶𝘁𝗵𝗼𝘂𝘁 𝗮 𝗥𝗘𝗠𝗦 (𝗥𝗶𝘀𝗸 𝗘𝘃𝗮𝗹𝘂𝗮𝘁𝗶𝗼𝗻 𝗮𝗻𝗱 𝗠𝗶𝘁𝗶𝗴𝗮𝘁𝗶𝗼𝗻 𝗦𝘁𝗿𝗮𝘁𝗲𝗴𝘆) 𝗿𝗲𝗾𝘂𝗶𝗿𝗲𝗺𝗲𝗻𝘁, signaling FDA confidence in its safety profile as it is engineered to offer better safety and efficacy than its competition. The price for AUCATZYL® is $525K (manufacturers invoice price for the infusion) not including administration costs. Having an optimal contract is key to managing this evolving exposure. Carbon provides specialty financial and clinical resources needed for your protection. Contact Carbon Stop Loss Solutions to learn how. https://lnkd.in/g_-XdUjA

Chronic disease is no longer just an issue for the elderly—its growing prevalence among working-age Americans is forcing self-insured employers to rethink their cost management strategies. To combat rising healthcare expenses, Jakki L., Director of Cost Containment of Carbon Stop Loss Solutions (formerly Sequoia Reinsurance), emphasizes the need for a multifaceted approach that includes claim payment integrity, preventative care programs and strategic contracting in this month’s issue of The Self Insurer from Self-Insurance Institute of America, Inc. Read the full story here: https://lnkd.in/eD2edw88   #strongerbydesign  #medicalbilling #paymentintegrity #theselfInsurer #managedcare #employerstoploss #stoploss

Welcome to our new chapter! Introducing Carbon.... carbonstoploss.com

Welcome to our new chapter! Introducing Carbon.... carbonstoploss.com

This Happened: The FDA has granted an accelerated approval for Tecelra, afamitresgene autoleucel (afami-cel), for treating patients with advanced synovial sarcoma. Tecelra is also the first FDA-approved T cell receptor (TCR) engineered gene therapy. The product is an autologous T cell immunotherapy composed of a patient's own T cells. T cells in Tecelra are modified to express a TCR that targets MAGE-A4, an antigen (substance that normally triggers your immune system) expressed by cancer cells in synovial sarcoma. The product is administered as a single intravenous dose. Patients received the T cells after leukapheresis and receiving lymphodepleting chemotherapy. The list price for the one-time therapy is $727,000, not including facility administration costs. The addressable patient population in the US is ~400 per year. Adaptimmune plans to have at least six to ten authorized treatment centers (ATCs) up and running this year and to onboard approximately 30 treatment centers within the first two years. Since Tecelra was granted an accelerated approval, continued approval may be contingent upon further clinical trial data. Specialty financial and clinical resources are needed to assess and contain this exposure. Contact Sequoia to assist with management and mitigation strategies for this increased uptake in risk. https://lnkd.in/ekxia_YV

Halfway through 2024 and the U.S. healthcare industry has already experienced some of the most dangerous cyberattacks in history, with unprecedented breaches in terms of stolen health and personal data.   Jakki Lynch, Director of Cost Containment at Sequoia, was featured in this article in the July edition of Self-Insurance Institute of America, Inc. Self-Insurer Magazine, the leading authority for the self-insurance industry.   Jakki brings awareness to issues that healthcare organizations should consider addressing to mitigate risk exposure for potential future cybersecurity attacks and data breaches.   Read the full story here: https://lnkd.in/g3G7fGBk    

With the explosion in popularity of weight-loss drugs, employers are navigating the rise in medical expenses and potential long-term impacts. Jakki Lynch, Director of Cost Containment at Sequoia, was featured in this article in the June edition of The Self-Insurer Magazine, the leading authority for the self-insurance industry. Jakki covers key data and insights around obesity and potential side effects of popular weight-loss drugs. Read the full story at: https://lnkd.in/gcy_-xkH