Mesoblast extends payer coverage for Ryoncil to over 100M U.S. lives

The company states: “Mesoblast (MESO) announced that it has continued to expand coverage for Ryoncil, the first mesenchymal stromal cell therapy approved by U.S. Food and Drug Administration for an y indication, to 104 million US lives insured by government and commercial payers. To date, 37 of the 51 states provide fee-for-service Medicaid coverage for Ryoncil through Orphan Drug Lists or medical exception / prior authorization (PA) process, representing 20 million covered lives, or 80% of the total Medicaid fee-for-service lives covered. The remainder will come on line July 1, 2025 with mandatory coverage for 24 million lives. Commercial plans representing private payers and managed Medicaid have published policies, prior authorization, and formulary lists in place for Ryoncil(R) covering 84 million lives. This number does not include the Medical Exceptions policies for Ryoncil(R) which are in place with the majority of commercial payers. Many plans do not publish policies for ultra rare diseases such as steroid-refractory acute graft versus host disease and manage through PA and medical exception, so the number to date is an underestimate of the total commercial coverage already achieved.”