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Sickle Cell Disease Gene Therapies Exagamglogene Autotemcel (Casgevy) and Lovotibeglogene Autotemcel (Lyfgenia)

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Sickle cell disease gene therapies are a covered benefit for Texas Medicaid clients. Below is more information on these gene therapies:

  • Casgevy (exagamglogene autotemcel) is an autologous genome-edited hematopoietic stem cell-based gene therapy indicated for the treatment of clients 12 years and older with sickle cell disease (SCD) with recurrent vaso-occlusive crises or transfusion-dependent ß-thalassemia.
  • Lyfgenia (lovotibeglogene autotemcel) is an autologous hematopoietic stem cell-based gene therapy indicated for the treatment of clients 12 years of age or older with sickle cell disease and a history of vaso-occlusive events.

Coverage determinations are made on a case-by-case basis. Prior authorization criteria will be included in a future update of the Texas Medicaid Provider Procedures Manual (TMPPM).

Providers should call the TMHP Contact Center at 800-925-9126 with any questions related to prior authorization for fee-for-service clients. Providers should contact managed care organizations for managed care clients.