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A decade ago, I had pegged gene and cell therapies as the next frontier. As an investment banker, I was sure they would someday change how patients were treated. But a question from a biotech CEO started me thinking about not only how to pay for them, but how to offer guarantees for these therapies to payers who rightfully wanted reassurances that they were paying for something that works for their beneficiaries.

In the spring of 2013, I had just visited a lab focused on gene and cell therapies at Baylor College of Medicine. Bluebird Bio, which would soon launch a successful IPO, had licensed its technology from the same lab and was about to announce a major collaboration with Celgene and Baylor.

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