Embarc Benefit Protection

This is the first FDA-approved prescription gene therapy for people with inherited retinal disease at a cost of $850K (both eyes).¹

A $2.1M gene therapy for children under 2 years old with spinal muscular atrophy a potentially life-threatening condition.³

The financial protection against the high cost of ZOLGENSMA applies only to children born after the Embarc Benefit Protection solution is effective for their group health plan.

Used for a blood disorder known as beta thalassemia in patients who cannot make enough beta-globin and require regular red blood cell transfusions at a cost of $2.8M.⁴

With a cost of $3M,⁴ this gene therapy is for patients 4-17 years of age with early, active cerebral adrenoleukodystrophy (CALD)—a rare neuro-degenerative disease that can lead to progressive, irreversible loss of neurologic function and death.

A one-time gene therapy drug treatment with a projected cost of $3.5M⁵ for adults living with hemophilia B who currently use factor IX prophylaxis therapy, or have current or historical life-threatening hemorrhage, or have repeated, serious spontaneous bleeding episodes.

A one-time gene therapy drug treatment with a projected cost of $2.9M⁶ indicated for the treatment of adults with severe hemophilia A.

A one-time gene therapy drug treatment with a projected cost of $2M⁸ indicated for the treatment of patients 12 years of age and older with sickle cell disease and for transfusion-dependent beta thalassemia.

For existing Embarc Benefit Protection clients with effective dates of April 1, 2024 or earlier, all customers who meet the solution’s clinical and network criteria for CASGEVY (for treatment of sickle cell disease) will be able to access the therapy through Embarc Benefit Protection. For clients who join Embarc Benefit Protection after April 1, 2024, the financial protection extends only to customers who join the underlying medical coverage 30 days or more after the client is effective in Embarc Benefit Protection.

A one-time gene therapy drug treatment with a projected cost of $3.1M¹⁰ indicated for the treatment of patients 12 years of age and older with sickle cell disease.

For existing Embarc Benefit Protection clients with effective dates of April 1, 2024 or earlier, all customers who meet the solution’s clinical and network criteria for LYFGENIA will be able to access the therapy through Embarc Benefit Protection. For clients who join Embarc Benefit Protection after April 1, 2024, the financial protection extends only to customers who join the underlying medical coverage 30 days or more after the client is effective in Embarc Benefit Protection.

A one-time gene therapy drug treatment with a cost of $4.25M⁵ indicated for the treatment of children with pre-symptomatic late infantile, pre-symptomatic early juvenile and early symptomatic early juvenile metachromatic leukodystrophy (MLD).

A one-time gene therapy treatment with a cost of $3.5M¹¹ indicated for the treatment of adults with Hemophilia B who currently use Factor IX prophylaxis therapy, or have current or historical life-threatening hemorrhage, or have repeated, serious spontaneous bleeding episodes.