Maryland Medicaid to Expand Access to Gene Therapies for Sickle Cell Disease

Baltimore, MD, Sept. 15, 2025 — Maryland Medicaid participants can now more easily access cell and gene therapies for sickle cell disease as a result of Maryland’s participation in the federal Cell and Gene Therapy (CGT) Access Model. This move is expected to ensure better pricing for high-cost medications, helping to reduce costs and strengthen support for patients and families who need these life-changing treatments.

“Maryland is committed to providing innovative and accessible health solutions designed specifically for our residents,” said Dr. Meena Seshamani, Maryland Department of Health Secretary. “By signing on to the CGT Access Model, we are expanding the state’s ability to provide costly, life-saving treatments that will allow Medicaid participants access to the care they need.”

The CGT Access Model, administered by the Centers for Medicare & Medicaid Services (CMS), is a new federal initiative that tests whether CMS-led outcomes-based agreements (OBAs) can increase Medicaid beneficiaries’ access to innovative treatments, improve their health outcomes, and reduce healthcare costs for state Medicaid programs. Under the model, CMS negotiates outcomes-based supplemental rebate agreements with pharmaceutical manufacturers.

The two sickle cell therapies currently available through this model are already FDA-approved for eligible patients. Participation is estimated to save the State of Maryland more than $1 million per patient.

While Maryland Medicaid participants may already access these treatments through standard coverage, the state will begin receiving enhanced rebates and financial protections under the CGT Access Model starting January 1, 2026.

This initiative is a critical step in addressing the high cost of new cell and gene therapies, which has made them difficult for many to access. Sickle cell disease affects about 100,000 people nationwide and disproportionately impacts Black communities.

“These therapies mark a turning point in how we treat rare and life-threatening diseases like sickle cell,” said Dr. Djinge Lindsay, Chief Medical Officer. “This Model allows us to provide coverage for groundbreaking treatments based on results—not just costs—so more Marylanders can benefit from real medical breakthroughs.”

Approximately 3,000 Maryland Medicaid participants have sickle cell disease, though not all will meet the clinical criteria for these specific therapies. The treatments are currently available through two authorized centers within Maryland Medicaid’s provider network: the University of Maryland Medical Center in Baltimore and Children’s National Hospital in Washington, D.C.