Patient Access Infrastructure for Rare Disease

Gene therapies cost millions of dollars.
The infrastructure wasn't built for this.

Insurance authorization takes 8–12 weeks. 30% of prescribed patients never start treatment. And now CMS requires outcomes-based payments — with five-year patient tracking that no one provides. We built the infrastructure to make it all work.

Why It Matters

We don't get paid to promote drugs. That's the point.

Basion is a neutral party. We don't represent manufacturers, and we don't advocate for payers. We provide infrastructure that all sides can trust.

Faster approvals

Neutral documentation that payers actually trust

Fewer lost patients

30% of prescribed patients currently never start treatment

Outcomes you can verify

Neither manufacturers nor states are neutral arbiters. We are.

How We Help

Infrastructure for the Entire Patient Journey

Evidence Synthesis

Complete, evidence-based documentation that builds payer confidence and accelerates authorization decisions.

Our platform aggregates clinical literature, case reports, treatment guidelines, and the patient's complete medical history — producing a comprehensive briefing so patients and providers can make informed decisions about high-risk therapies.

Authorization

Time-to-therapy drops from 8–12 weeks to days. More prescribed patients start treatment.

We connect to the patient's record and the insurer's requirements, identify the gap, and generate the strongest possible case for medical necessity — citing FDA labels, trial data, clinical guidelines, and patient-specific history.

Escrow & Outcomes Administration

CMS CGT Model compliance. Commercial outcomes-based contract administration. The neutral infrastructure that makes value-based payment possible.

For outcomes-based contracts, we provide neutral infrastructure: five-year patient tracking, multi-source data aggregation from claims, clinical registries, and patient-reported outcomes, outcome verification against contract benchmarks, and escrow services for warranty payments.

The Regulatory Shift

CMS Now Requires Outcomes-Based Payments for Gene Therapies

In January 2025, CMS launched the Cell and Gene Therapy Access Model — the first federal program requiring outcomes-based payments for gene therapies.

What the model requires

  • Track patient outcomes for five years
  • Collect data at 30, 100, and 180 days, then annually
  • Aggregate from Medicaid claims, clinical registries, and patient surveys
  • Calculate rebates based on whether outcomes hit benchmarks
  • Operate across 33 states with different Medicaid systems

What we provide

  • Purpose-built outcomes tracking platform
  • Multi-source data aggregation (T-MSIS, CIBMTR, PROs)
  • Outcome verification and rebate calculation
  • Escrow services for warranty payments
  • Infrastructure designed for five-year patient relationships

This isn't optional. If you want Medicaid to cover your gene therapy, you need this infrastructure. Legacy hubs weren't built for it.

The Technology

Purpose-Built for Rare Disease Complexity

Building evidence synthesis and outcomes tracking for rare disease requires integrating medicine, patient biology, and payer policy simultaneously. No off-the-shelf AI can do this. We built purpose-built infrastructure across four layers.

Ecosystem Intelligence

The largest structured database of the rare disease landscape: 7,000+ diseases, 800+ pharma/biotech companies, 450+ payers with coverage policies and approval precedents, 2,500+ foundations, 15,000+ specialists. When we build an authorization case, we identify similar cases that were approved, the documentation that worked, and the payer-specific requirements that applied.

Medical Knowledge

Deep structured knowledge of rare disease biology: 10,000+ genes with variant annotations, 15,000+ phenotypes, 3,000+ biological pathways, 500,000+ indexed publications with extracted clinical relationships. We trace from a patient's genotype through the affected pathway to the therapeutic mechanism — providing the complete evidence picture.

Patient Understanding

Longitudinal patient models built through every interaction. Health records, patient-reported symptoms, lab trends, device data, treatment responses. This makes five-year outcomes tracking clinically meaningful — not just administrative box-checking.

Specialized AI

50+ purpose-built AI agents across patient, caregiver, advocate, and professional use cases. Each is trained on domain-specific data and constrained to appropriate actions. The authorization agent knows which arguments work with which payers. The trial finder understands rare disease eligibility criteria.

Why Basion

Built for Where Healthcare Is Going

Legacy hub services companies were built for specialty drugs — they bill for nurse hours and phone calls. That model breaks at multi-million dollar gene therapies with five-year outcome warranties.

Legacy Hubs
Basion
Authorization
Manual, 8–12 weeks
AI-powered, days
Neutrality
Manufacturer-funded
Independent — no drug promotion
Knowledge infrastructure
None
Structured knowledge graph with 500K+ publications
Patient data
6–12 month engagement
Longitudinal models across years
Outcomes tracking
Not a core function
Purpose-built for 5-year tracking
Escrow capability
None
Neutral warranty payment administration
Outcomes-based contracts
Not designed for it
Built for CMS CGT Model compliance
Partnership Model

How We Work With You

1

Pre-Launch

We design patient services infrastructure during BLA preparation — so it's operational at approval, not months after. We begin building the evidence base, mapping the payer landscape, and preparing authorization protocols for your specific therapy.

2

At Launch

Evidence synthesis and authorization services that recover patients lost to administrative friction. Our platform builds the strongest possible case for medical necessity, informed by clinical data, payer-specific requirements, and similar approved cases.

3

Post-Treatment

Outcomes tracking and escrow administration for CMS and commercial outcomes-based contracts. Five-year data collection, outcome verification against benchmarks, and warranty payment management.

Get Started

Let's Talk About Your Pipeline

Whether you're preparing for a launch, navigating the CMS CGT Model, or looking to improve patient access for an existing therapy — we'd welcome the conversation.

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