Presented herein are systems and methods for structuring the financing of high cost therapies such as GCTs to address the issues of high-upfront cost (affordability), uncertain durability of the treatment, and portability/transferability of the liability. In certain embodiments, the systems and methods described herein involve a combination of (a) a uniquely-designed, multi-year structured loan that facilitates portability, (b) a performance based guarantee of efficacy in the form of a value based agreement that may be tied to the tenure of the loan, and/or (c) securitization of the loan.