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Cost of Goods Sold Analysis for Manufacturing mRNA-Based Cell and Gene Therapies

Lieberthal, R. D.; Buontempo, P.; Harmon, B.; Omosule, A.; Washabaugh, M.; Whittaker, A.

2026-05-06 health economics
10.64898/2026.05.04.26352406 medRxiv
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BackgroundCell and gene therapies (CGT) represent a transformative class of medical interventions, yet their high production costs limit patient access. Understanding the structure of manufacturing costs is essential for informing policies that can expand access to these therapies. ObjectiveThis study develops and applies a cost-of-goods-sold (COGS) model to analyze the contributors to manufacturing costs for mRNA-based CGT, with application to a wide range of current and future therapies. MethodsAn Excel-based COGS model was constructed based on cost categories for CGT. Two mRNA-based products at commercial scale were used to populate the model: an mRNA vaccine and a therapeutic mRNA gene therapy. Cost inputs were drawn from vendor pricing, peer-reviewed and grey literature, and expert consultation with CGT manufacturing specialists. Three scenarios (worst, base, and best case) were modeled across six cost categories: materials, consumables, capital, labor, licenses, and royalties. A tornado diagram sensitivity analysis was conducted to identify key cost drivers. The mRNA vaccine was used to build and validate the model strucutre using publicly available data sources. The therapeutic mRNA therapy was used as the main use case for illustration and sensitivity analysis. ResultsUnder base-case assumptions, the estimated cost per dose for the therapeutic mRNA product is $56.09, ranging from $3.68 (best case) to $383.22 (worst case). Licensing and royalty fees together account for approximately 83% of total base-case COGS ($6,996,000 and $6,960,000 per production run, respectively, out of $16,825,597 total). Excluding these fees, material costs represent the largest remaining share (61%), followed by consumables (34%), capital (4%), and labor (1%). Sensitivity analysis confirms that licensing and royalty assumptions are the dominant source of uncertainty in the model. ConclusionsLicensing and royalty fees are the primary driver of mRNA-based CGT production costs and represent the greatest opportunity for cost reduction through policy intervention. Strategic priorities for cost reduction should focus on optimizing reagent utilization, increasing platform potency, and expanding use of contract development and manufacturing organizations (CDMOs) to reduce capital and labor costs. Key PointsProducing an example mRNA gene therapy costs about $56 per dose to manufacture, driven almost entirely driven by fees paid to patent holders for the underlying technology. Licensing and royalty fees cost roughly 83 cents of every dollar spent on these new biopharmaceutical products. Until that changes, the gap between what therapies cost to make and what patients and payers are charged will remain very wide.

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