ISSUE: Biopharmaceutical innovation has the potential to bring significant value to payers, patients, and society. However, despite being cost effective, these therapies may place financial burden on payers due to switching of patients between payers and a time lag between the most significant costs and benefits.  The recent media coverage on Hepatitis C highlights this point. Are the challenges presented by Hepatitis C unique or is there a need for a broader policy approach on alternative financing such as long-term financing by third party?  Dr. Noam Kirson will moderate and discuss recent research on the distribution of costs and benefits among payers for five disease archetypes including hepatitis C, beta thalassemia, Alzheimer’s disease, Familial hypercholesterolemia, and patients with prior cardiovascular disease. Jonathan Blum will discuss whether alternative financing approaches are needed from the commercial insurance perspective and Jeff Myers from the Medicaid perspective.  Michael Ciarametaro will provide the industry perspective. OVERVIEW: Financial risk in the US healthcare system is divided among three main payer types: commercial, Medicare, and Medicaid. The result is that no single payer has clinical and financial responsibility for the entirety of a patient’s life. At the same time, the chronic disease burden in the US is growing as approximately 50% of the US population over 18 has one or more chronic conditions. For many chronic conditions, the most significant outcomes occur well after disease onset. However, treatment often begins closer to the disease onset. The separation between treatment start and key outcomes creates the potential for one payer to bear treatment costs, while a different payer benefits from the savings.  The division of benefits and costs contributes to affordability concerns. For example, would the affordability of Hepatitis C treatments been a concern if the majority of benefits occurred within one or two years of treatment?