W

hen Novartis (NVS) announced an eye-popping $475,000 price for its new gene-therapy cancer treatment last month, the company also touted a money-back guarantee: if a patient fails to respond in the first month, there will be no charge. The deal generated praise, but also questions about the extent to which payers and patients will benefit. Several Democratic lawmakers are now seeking answers.

Unfortunately, details have not been released, which raises some key issues. For instance, it remains unclear how patient responses to the drug — which is called Kymriah and was approved to treat children with an aggressive form of leukemia — will be measured. Moreover, a 30-day cutoff can easily work in the company’s favor, since a short-term benefit is more typical among cancer patients.

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