bluebird bio, Inc. (NASDAQ: BLUE) (“bluebird bio”) today
announced it has signed its first Medicaid outcomes-based agreement
for LYFGENIA™ (lovotibeglogene autotemcel, also known as lovo-cel)
with the state of Michigan. LYFGENIA is a one-time gene therapy
approved for the treatment of patients 12 years of age and older
with sickle cell disease and a history of vaso-occlusive events
(VOEs). Approximately 50 percent of individuals living with sickle
cell disease in the U.S. are insured by Medicaid.
“Our commercial approach is built on the principle that people
with sickle cell disease insured through Medicaid deserve the same
timely access to gene therapy as patients with other forms of
insurance,” said Tom Klima, chief commercial & operating
officer, bluebird bio. “We are extremely pleased to have reached
this agreement with Michigan Medicaid and with the momentum behind
our reimbursement negotiations across the board just months
following approval, which underscores payers’ shared commitment to
equitable access and understanding of the value that LYFGENIA can
bring to people living with sickle cell disease, their caregivers,
and the healthcare system.”
bluebird is an established leader in developing and implementing
innovative, value-based contracting approaches. The Company has
designed outcomes-based contract options unique to LYFGENIA that
offer payers meaningful risk sharing tied to VOE-related
hospitalizations—a claims-based metric that is directly correlated
with clinical benefit and aligned with study endpoints in the
LYFGENIA clinical development program—with patients followed for
three years. bluebird’s outcomes-based contract offering for State
Medicaid Agencies was designed with direct input from government
payers to specifically address the challenges they face in adapting
to provide access to one-time, transformative treatments, and
reflects the Company’s unmatched experience delivering gene
therapies in the commercial setting.
bluebird is in ongoing discussions with more than 15 Medicaid
agencies representing 80 percent of Medicaid-insured individuals in
the U.S. Additionally, bluebird has signed multiple outcomes-based
agreements for LYFGENIA with national commercial payer
organizations representing dozens of downstream plans and covering
approximately 200 million U.S. lives.
bluebird is also engaged with the Center for Medicare and
Medicaid Innovation (CMMI) on its Cell and Gene Therapy Access
Demonstration Model, which is anticipated to start in 2025.
About LYFGENIA™ (lovotibeglogene autotemcel) or
lovo-cel
LYFGENIA is a one-time ex-vivo lentiviral vector gene therapy
approved for the treatment of patients 12 years of age or older
with sickle cell disease and a history of vaso-occlusive events
(VOEs). LYFGENIA works by adding a functional β-globin gene to
patients’ own hematopoietic (blood) stem cells (HSCs). Durable
production of adult hemoglobin with anti-sickling properties
(HbAT87Q) is possible following successful engraftment. HbAT87Q has
a similar oxygen-binding affinity to wild-type HbA, limits sickling
of red blood cells and has the potential to reduce and VOEs.
The Phase 1/2 HGB-206 study of LYFGENIA is complete and the
Phase 3 HGB-210 study evaluating LYFGENIA is ongoing. bluebird bio
is also conducting a long-term safety and efficacy follow-up study
(LTF-307) for patients with sickle cell disease who have been
treated with LYFGENIA in bluebird bio-sponsored clinical
studies.
Indication
LYFGENIA is indicated for the treatment of patients 12 years of
age or older with sickle cell disease and a history of
vaso-occlusive events (VOEs).
Limitations of Use
Following treatment with LYFGENIA, patients with α-thalassemia
trait (-α3.7/-α3.7) may experience anemia with erythroid dysplasia
that may require chronic red blood cell transfusions. LYFGENIA has
not been studied in patients with more than two α-globin gene
deletions.
Important Safety Information
Boxed WARNING: HEMATOLOGIC MALIGNANCY
Hematologic malignancy has occurred in patients treated with
LYFGENIA. Monitor patients closely for evidence of malignancy
through complete blood counts at least every 6 months and through
integration site analysis at Months 6, 12, and as
warranted.
Hematologic Malignancy
Hematologic malignancy has occurred in patients treated with
LYFGENIA (Study 1, Group A). At the time of initial product
approval, two patients treated with an earlier version of LYFGENIA
using a different manufacturing process and transplant procedure
(Study 1, Group A) developed acute myeloid leukemia (AML). One
patient with α-thalassemia trait (Study 1, Group C) has been
diagnosed with myelodysplastic syndrome (MDS).
The additional hematopoietic stress associated with
mobilization, conditioning, and infusion of LYFGENIA, including the
need to regenerate the hematopoietic system, may increase the risk
of a hematologic malignancy. Patients with sickle cell disease have
an increased risk of hematologic malignancy as compared to the
general population.
Patients treated with LYFGENIA may develop hematologic
malignancies and should have lifelong monitoring. Monitor for
hematologic malignancies with a complete blood count (with
differential) at least every 6 months for at least 15 years after
treatment with LYFGENIA, and integration site analysis at Months 6,
12, and as warranted.
In the event that a malignancy occurs, contact bluebird bio at
1-833-999-6378 for reporting and to obtain instructions on
collection of samples for testing.
Post-Marketing Long Term Follow-Up Study: Patients who intend to
receive treatment with LYFGENIA are encouraged to enroll in the
study, as available, to assess the long-term safety of LYFGENIA and
the risk of malignancies occurring after treatment with LYFGENIA by
calling bluebird bio at 1-833-999-6378. The study includes
monitoring (at pre-specified intervals) for clonal expansion.
Delayed Platelet Engraftment
Delayed platelet engraftment has been observed with LYFGENIA.
Bleeding risk is increased prior to platelet engraftment and may
continue after engraftment in patients with prolonged
thrombocytopenia. Two patients (4%) required more than 100 days
post treatment with LYFGENIA to achieve platelet engraftment.
Patients should be made aware of the risk of bleeding until
platelet recovery has been achieved. Monitor patients for
thrombocytopenia and bleeding according to standard guidelines.
Conduct frequent platelet counts until platelet engraftment and
platelet recovery are achieved. Perform blood cell count
determination and other appropriate testing whenever clinical
symptoms suggestive of bleeding arise.
Neutrophil Engraftment Failure
There is a potential risk of neutrophil engraftment failure
after treatment with LYFGENIA. Neutrophil engraftment failure is
defined as failure to achieve three consecutive absolute neutrophil
counts (ANC) ≥ 0.5 × 109 cells/L obtained on different days by Day
43 after infusion of LYFGENIA. Monitor neutrophil counts until
engraftment has been achieved. If neutrophil engraftment failure
occurs in a patient treated with LYFGENIA, provide rescue treatment
with the back-up collection of CD34+ cells.
Insertional Oncogenesis
There is a potential risk of lentiviral vector-mediated
insertional oncogenesis after treatment with LYFGENIA.
Hypersensitivity Reactions
Allergic reactions may occur with the infusion of LYFGENIA. The
dimethyl sulfoxide (DMSO) or dextran 40 in LYFGENIA may cause
hypersensitivity reactions, including anaphylaxis.
Anti-retroviral Use
Patients should not take prophylactic HIV anti-retroviral
medications for at least one month prior to mobilization and until
all cycles of apheresis are completed. There are some long-acting
anti-retroviral medications that may require a longer duration of
discontinuation for elimination of the medication. If a patient is
taking anti-retrovirals for HIV prophylaxis, confirm a negative
test for HIV before beginning mobilization and apheresis of CD34+
cells.
Hydroxyurea Use
Patients should not take hydroxyurea for at least 2 months prior
to mobilization and until all cycles of apheresis are completed. If
hydroxyurea is administered between mobilization and conditioning,
discontinue 2 days prior to initiation of conditioning.
Iron Chelation
Drug-drug interactions between iron chelators and the
mobilization process and myeloablative conditioning agent must be
considered. Iron chelators should be discontinued at least 7 days
prior to initiation of mobilization or conditioning. Do not
administer myelosuppressive iron chelators (e.g., deferiprone) for
6 months post-treatment with LYFGENIA. Non-myelosuppressive iron
chelation should be restarted no sooner than 3 months after
LYFGENIA infusion. Phlebotomy can be used in lieu of iron
chelation, when appropriate.
Interference with PCR-based Testing
Patients who have received LYFGENIA are likely to test positive
by polymerase chain reaction (PCR) assays for HIV due to integrated
BB305 LVV proviral DNA, resulting in a possible false-positive PCR
assay test result for HIV. Therefore, patients who have received
LYFGENIA should not be screened for HIV infection using a PCR-based
assay.
Adverse Reactions
The most common adverse reactions ≥ Grade 3 (incidence ≥ 20%)
were stomatitis, thrombocytopenia, neutropenia, febrile
neutropenia, anemia, and leukopenia.
Three patients died during LYFGENIA clinical trials; one from
sudden cardiac death due to underlying disease and two from acute
myeloid leukemia who were treated with an earlier version of
LYFGENIA using a different manufacturing process and transplant
procedure (Study 1, Group A).
Pregnancy/Lactation
Advise patients of the risks associated with myeloablative
conditioning agents, including on pregnancy and fertility.
LYFGENIA should not be administered to women who are pregnant,
and pregnancy after LYFGENIA infusion should be discussed with the
treating physician.
LYFGENIA is not recommended for women who are breastfeeding, and
breastfeeding after LYFGENIA infusion should be discussed with the
treating physician.
Females and Males of Reproductive Potential
A negative serum pregnancy test must be confirmed prior to the
start of mobilization and re-confirmed prior to conditioning
procedures and before LYFGENIA administration.
Women of childbearing potential and men capable of fathering a
child should use an effective method of contraception
(intra-uterine device or combination of hormonal and barrier
contraception) from start of mobilization through at least 6 months
after administration of LYFGENIA.
Advise patients of the options for fertility preservation.
Please see full Prescribing Information for
LYFGENIA including Boxed WARNING and Medication
Guide.
About bluebird bio, Inc.
bluebird bio is pursuing curative gene therapies to give
patients and their families more bluebird days.
Founded in 2010, bluebird has been setting the standard for gene
therapy for more than a decade—first as a scientific pioneer and
now as a commercial leader. bluebird has an unrivaled track record
in bringing the promise of gene therapy out of clinical studies and
into the real-world setting, having secured FDA approvals for three
therapies in under two years. Today, we are proving and scaling the
commercial model for gene therapy and delivering innovative
solutions for access to patients, providers, and payers.
With a dedicated focus on severe genetic diseases, bluebird has
the largest and deepest ex-vivo gene therapy data set in the field,
with industry-leading programs for sickle cell disease,
β-thalassemia and cerebral adrenoleukodystrophy. We custom design
each of our therapies to address the underlying cause of disease
and have developed in-depth and effective analytical methods to
understand the safety of our lentiviral vector technologies and
drive the field of gene therapy forward.
bluebird continues to forge new paths as a standalone commercial
gene therapy company, combining our real-world experience with a
deep commitment to patient communities and a people-centric culture
that attracts and grows a diverse flock of dedicated birds.
bluebird bio and LYFGENIA are registered trademarks of bluebird
bio, Inc. All rights reserved.
Cautionary Statement Regarding Forward-Looking
Statements
This press release contains “forward-looking statements” within
the meaning of the Private Securities Litigation Reform Act of
1995. All statements that are not statements of historical facts
are, or may be deemed to be, forward-looking statements, such as
statements regarding the momentum around the Company’s launch of
LYFGENIA and its ability to successfully partner with payers and
CMMI. Such forward-looking statements are based on historical
performance and current expectations and projections about
bluebird’s future goals, plans and objectives and involve inherent
risks, assumptions and uncertainties, including internal or
external factors that could delay, divert or change any of them in
the next several years, that are difficult to predict, may be
beyond bluebird’s control and could cause bluebird’s future goals,
plans and objectives to differ materially from those expressed in,
or implied by, the statements. No forward-looking statement can be
guaranteed. Forward-looking statements in this press release should
be evaluated together with the many risks and uncertainties that
affect bluebird bio’s business, particularly those identified in
the risk factors discussion in bluebird bio’s Annual Report on Form
10-K for the year ended December 31, 2022, as updated by its
subsequent Quarterly Reports on Form 10-Q, Current Reports on Form
8-K and other filings with the Securities and Exchange Commission.
These risks and uncertainties include, but are not limited to:
delays and challenges in bluebird’s commercialization and
manufacturing of its products; the risk that the efficacy and
safety results from bluebird’s prior and ongoing clinical trials
will not continue or be seen in the commercial context; the risk
that there is not sufficient patient demand or payer reimbursement
to support continued commercialization of LYFGENIA; the risk of
insertional oncogenic or other safety events associated with
lentiviral vector, drug product, or myeloablation, including the
risk of hematologic malignancy; and the risk that bluebird’s
products, including LYFGENIA, will not be successfully
commercialized. The forward-looking statements included in this
document are made only as of the date of this document and except
as otherwise required by applicable law, bluebird bio undertakes no
obligation to publicly update or revise any forward-looking
statement, whether as a result of new information, future events,
changed circumstances or otherwise
View source
version on businesswire.com: https://www.businesswire.com/news/home/20240311251950/en/
Media: Jess Rowlands, 857-299-6103
jess.rowlands@bluebirdbio.com
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