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After Bluebird Bio (BLUE) announced plans this week to end commercial operations in Europe, the move is raising fresh questions about the extent to which selling pricey gene and cell therapy treatments is viable for small biotechs in one of the world’s biggest markets.

In explaining the move, the biotech complained that it has become a losing proposition trying to convince European Union member states to make large upfront payments for therapies that can save health care systems much higher costs later. So instead, the company is shifting its focus to the U.S., where it is more likely to get reimbursed at the desired prices.

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