Pharmacy's Rising Role in Cell and Gene Therapy: Zahra Mamoudjafari, PharmD, MBA

As cell and gene therapies (CGTs) continue to receive regulatory approvals at an accelerating pace, health care institutions are grappling with a widening gap between clinical innovation and operational readiness. Zahra Mahmoudjafari, PharmD, MBA, BCOP, FHOPA, a clinical pharmacy manager in the Division of Hematologic Malignancies and Cellular Therapeutics at the University of Kansas Health System, has spent over a decade working at the intersection of these challenges, and recently published a framework aimed at helping institutions build more durable CGT programs.

In this interview, Mamoudjafari described how most programs have developed reactively, standing up infrastructure only after a product approval rather than in anticipation of it. Her article outlines 8 interdependent domains—from financial strategy and clinical workflows to long-term patient follow-up—that she argues must all function together for a program to succeed.

Among the most underestimated of these domains, she contends, is financial and reimbursement strategy. Prior authorization delays, she explained, can cascade quickly: a stalled approval doesn't just create an administrative headache, it can delay treatment timelines and impede access for patients with relapsed or refractory disease, disrupt manufacturing schedules, and potentially render a patient ineligible as their condition progresses.

Mamoudjafari also spoke to pharmacy's evolving centrality in these programs. Historically rooted in the transplant setting, CGT infrastructure is now expanding across oncology and beyond into areas like gene therapy for nonhematologic conditions, making pharmacy's cross-departmental reach increasingly valuable.

With new therapies targeting larger patient populations entering the pipeline, she acknowledged her framework will require ongoing updates. But its core message is clear: sustainable CGT programs are not built by limiting patient access; they are built by designing systems capable of delivering these therapies consistently and responsibly over time.

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