Cell and Gene Therapy Patient Access and Reimbursement Market Revenue and Forecast by 2033

15 Jul 2025

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Table of Content

1. Cell and Gene Therapy Patient Access and Reimbursement Market Revenue and Trends 2025 to 2033 2. What are the Major Factors Boosting the Growth of the Cell and Gene Therapy Patient Access and Reimbursement Market? 3. Segment Insights 4. Regional Insights 5. Cell and Gene Therapy Patient Access and Reimbursement Market Coverage 6. Cell and Gene Therapy Patient Access and Reimbursement Market Key Players

Cell and Gene Therapy Patient Access and Reimbursement Market Revenue and Trends 2025 to 2033

The cell and gene therapy patient access and reimbursement market is expanding through 2033, fueled by outcome-based agreements, annuity payment models, and increased payer acceptance of high-cost personalized treatments. The growth of the market is attributed to the increased development of innovative payment models such as outcomes-based agreements, staggered installment plans, and expanded medicare/medicaid coverage.

What are the Major Factors Boosting the Growth of the Cell and Gene Therapy Patient Access and Reimbursement Market?

The market for cell and gene therapy (CGT) patient access and reimbursement is poised for rapid growth, driven by the surge in regulatory approvals for advanced therapies and the growing number of successful clinical outcomes. As treatments for rare and chronic diseases demonstrate significant success, stakeholders, including payors, providers, and manufacturers, are increasingly encouraged to establish access pathways. The expansion of value-based pricing is also driving the adoption of outcome-based reimbursement, which links costs to clinical benefits. Another key driver is the rising incidence of genetic disorders and cancers, resulting in a patient base seeking personalized medicine. Furthermore, collaborations between the public and private sectors are accelerating, with new policies and infrastructure emerging to support complex reimbursement models.

Segment Insights

• By therapy type, the CAR-T cell therapies segment held the largest share of the market in 2024. These therapies have reshaped oncology care due to their proven efficacy in treating various cancers. The increasing number of regulatory approvals for CAR-T cell therapies further bolsters the segment's growth.
• By reimbursement model, the traditional lump-sum payment segment led the market in 2024 due to the increased patient demand for full coverage. This model enables simple payment flows, reduces administrative burden, and provides predictable financial consequences for both payers and providers.
• By payer type, the public payers segment dominated the market in 2024 due to their established equitable patient access. Increased government initiatives aimed at improving reimbursement models, along with a high demand for cost-effective solutions, further support segmental growth.
• By treatment setting, the hospital & specialty centers segment dominated the market in 2024 due to the increased patient population. Since these settings deliver CGTs to a large patient base, they often require specialized expertise. The high treatment costs in these settings increase the demand for effective payer outreach practices to ensure the best access and utilization for patients.
• By patient demographics, the adult segment dominated the market in 2024. This is mainly due to the increased prevalence of cancer and genetic disorders among this demographic. Older adults often require long-term care. However, reimbursement increases the affordability of long-term care.

Regional Insights

North America dominated the cell and gene therapy patient access and reimbursement market, holding the largest revenue share in 2024. This is primarily due to the increased support from regulatory bodies, which provide pathways for accelerated approvals. The U.S. is a major contributor to the market. The rising development of CGTs and innovative FDA pathways for regenerative medicine, along with the emergence of new payment models, support market growth.

Asia Pacific is emerging as the fastest-growing area. China, Japan, and South Korea are making efforts to enhance CGT manufacturing capabilities, supporting market growth. The rising prevalence of various life-threatening diseases is boosting the demand for cell and gene therapies, contributing to market growth.

Cell and Gene Therapy Patient Access and Reimbursement Market Coverage

Recent Developments

• In April 2024, DePinto presented an innovative payment model for cell and gene therapies during a session at Asembia’s 2024 Specialty Pharmacy Summit held in Las Vegas, Nevada.
  (Source: https://www.ajmc.com)
• In January 2024, the Centers for Medicare and Medicaid Services (CMS) announced the implementation of its Cell and Gene Therapy (CGT) Access Model. This model enables CMS to negotiate multi-state, outcomes-based agreements (OBAs) on behalf of participating states for selected CGTs with participating manufacturers.
  (Source: https://advisory.avalerehealth.com)

Cell and Gene Therapy Patient Access and Reimbursement Market Key Players

• Novartis AG (Kymriah)
• Gilead/Kite (Yescarta, Tecartus)
• Spark Therapeutics (Luxturna)
• Bluebird Bio (Zynteglo, Lyfgenia)
• Vertex & CRISPR Therapeutics (Casgevy)
• Spark Therapeutics (Luxturna)
• Roche / Spark
• Roche / Novartis partnership
• US CMS (Medicare/Medicaid payers)
• Italy’s AIFA
• NHS England
• European payer consortia (Nordic, Benelux)
• Harvard Pilgrim Health Care
• CMS innovation / NTAP programs
• Express Scripts / Accredo
• Hospital networks (CAR T-certified centers)
• Duke Margolis Health Policy Consortium
• Clarivate / Decision Resources (consulting)
• American Society of Gene & Cell Therapy (ASGCT)
• Biogen (Spinraza) & other bench-to-bedside enablers

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