Frequently Asked Questions (FAQs)
About Aradigm
What is Aradigm?
We stand at a remarkable moment in science. Cell and gene therapies can treat diseases that were once thought to be untreatable, but these therapies carry a steep price tag, and it varies widely, with treatments costing up to $4 million per patient. Aradigm was created because this is a problem that requires more than a simple fix.
Aradigm is a public benefit corporation that was created to provide sustainable access to cell and gene therapies (CGTs). We have created a novel financial and delivery model that addresses the challenges facing every stakeholder — employers, health insurers, healthcare providers, pharmaceutical manufacturers, and most importantly, patients.
Understanding Cell and Gene Therapies
What are cell and gene therapies (CGTs)?
Cell and gene therapies are breakthrough medical treatments that work at the cellular or genetic level to cure or dramatically improve outcomes for previously untreatable diseases. These therapies can address the root cause of conditions rather than just managing symptoms, offering the potential for one-time curative treatments.
How expensive are cell and gene therapies?
With a price tag that is widely variable and can range up to $4 million per patient, the cost is not just high; it's volatile. This volatility creates unbearable and misaligned financial risk for every stakeholder.
Why are cell and gene therapies so expensive?
Cell and gene therapies require massive R&D investments, complex manufacturing personalized to individual cases, and specialized clinical expertise to deliver. Manufacturers must recoup these costs while facing uncertainty about whether payers will authorize coverage and providers will adopt their therapies.
Why Cell and Gene Therapies Are Hard to Access
What is the biggest barrier to accessing cell and gene therapies?
A central barrier is financial: with treatments costing up to $4 million per patient per patient, these therapies create catastrophic, unpredictable costs that lead to coverage exclusions, provider hesitation, and patients being denied life-changing treatments.
How does the current system fail to manage CGT costs?
Cell and gene therapies can cost up to $4 million per patient. Our healthcare system simply isn’t built for delivering or paying for these kinds of medicines. Fragmentation in the healthcare system creates misaligned incentives across all stakeholders:
Employers and insurers face unpredictable cost spikes from just one or two claims, with no guarantee they'll see long-term benefits if patients switch plans.
Healthcare providers must absorb enormous upfront costs with unpredictable patient volume.
Manufacturers face uncertainty about whether payers will authorize and providers will administer their therapies.
Patients navigate extremely complex, inconsistent treatment pathways.
What happens without a comprehensive solution?
Without clear delivery and payment systems, health plans and employers are facing the choice of whether to exclude or restrict coverage for these therapies, leaving patients without access to potentially life-changing treatments, or bear unpredictable costs. For providers, the problem is similar. Without predictable reimbursement models and patient volumes, they may not deliver these treatments, leaving patients with limited access.
How Aradigm Works
How does Aradigm's model work?
Our model is built on three pillars that align the entire market:
For Purchasers (Employers) and Payers (Insurers): We create one large risk pool. They pay a predictable, set premium, and we "carve out" their risk by taking full responsibility for paying all CGT claims. This eliminates their volatility.
For Providers (Hospitals): We contract with a select network of "centers of excellence". We remove their financial risk by paying the high upfront costs for these therapies. In return, we get favorable reimbursement rates and can ensure quality of care.
For Manufacturers: We contract directly for volume-based discounts and build in performance guarantees. We then monitor patients long-term to ensure the therapies work, and we can claw back payments if they don't.
What is a "transparent pass-through business model"? It's a model built on alignment, not arbitrage. We charge a small, fixed percentage from the risk pool to cover our expenses. The rest of the pool is used to pay claims. If we don't use the total by the end of the year, we return the unspent funds to the contributors. Our success is tied to efficiently managing the market, not to denying care.
How does Aradigm reduce costs while improving access?
We are a market-maker designed to reduce total cost and risk. The current system is fragmented with misaligned "middles" that shift costs. Our transparent, pass-through model creates value in three ways:
Reduces Unit Cost: We negotiate volume-based discounts with manufacturers.
Reduces Volatility: We absorb 100% of the financial risk for payers via a pooled model.
Reduces Waste: We tie payment to performance and track long-term outcomes. We return any unspent funds, so our incentive is 100% aligned with managing the market efficiently.
How do you know Aradigm’s model will work?
We are not launching with a theory; we are launching with a solution built by the market. We spent six months co-designing the model with a foundational "development cohort" that included 15 of the nation's top 50 largest employers and 6 leading payers (three national, three regional).
What makes Aradigm different from other solutions?
Aradigm was founded after an extensive search for a market solution to the CGT crisis came up empty. We found piecemeal approaches, but no comprehensive solution existed. Recognizing this critical gap, a16z led our $5M Seed round in 2024 to build the solution from the ground up.
What is a PBM and how is Aradigm different?
Pharmacy Benefit Managers, or PBMs, manage prescription drug benefits for health plans and employers. They negotiate drug prices with manufacturers, determine which drugs are covered, process pharmacy claims, and manage utilization. Essentially, they serve as intermediaries between payers, pharmacies, and drug manufacturers, and they are primarily focused on managing costs and utilization for medications.
This is fundamentally different from what Aradigm does. Instead of managing costs for the existing pharmacy infrastructure, we're building an entirely new market infrastructure because the health care system simply wasn't designed to handle the cost of CGT – therapies covered under the medical benefit. By creating a new financial and delivery model, we take on the full financial risk through a specialized risk pool, contracts with a national network of centers of excellence to give providers volume and rate certainty, and concierge patient support. Our model is driven entirely by our mission to unite key stakeholders in the CGT ecosystem to create sustainable and equitable access to life-saving therapies.
Aradigm as a Public Benefit Corporation
What is a public benefit corporation (PBC)?
A public benefit corporation (PBC) is a company that has legally committed to making a positive impact on society, not just making a profit. This means that Aradigm’s mission to create sustainable and equitable access to life-saving CGT therapies is codified directly into our corporate structure, and it drives everything we do. We have explicit goals in our bylaws around this and we have a documented set of measurable commitments that we hold ourselves accountable to achieving.
Why did Aradigm choose to be a Public Benefit Corporation?
We chose this structure to hard-wire our mission into our corporate DNA. Our "public benefit" is to create sustainable and affordable access to transformative treatments. This legally binds us to serve the interests of all our stakeholders—patients, payers, providers, and purchasers—not just shareholders. Our transparent business model is a direct reflection of this mission-driven approach.