Exagamglogene Autotemcel (Casgevy)

Key Messages

• Canada’s Drug Agency (CDA-AMC) recommends that Casgevy be reimbursed by public drug plans for the treatment of sickle cell disease (SCD) with recurrent vaso-occlusive crises (VOCs), if certain conditions are met.
• Casgevy should only be covered to treat patients aged 12 years or older with a diagnosis of severe SCD (defined as documented severe SCD genotype and a history of at least 2 severe VOC events each year for the last 2 years). Patients aged 12 to 16 years must have normal transcranial Doppler (TCD) velocity in the middle cerebral artery and the internal carotid artery. Patients aged 12 to 18 years should not have had 2 or more abnormal TCD results. Patients also need to meet specific performance status criteria, be eligible for an autologous stem cell transplant, not have a willing 10/10 HLA-matched related donor available, and should not have previously received an allogenic-hematopoietic stem cell transplant (allo-HSCT) or gene therapy. Additionally, patients must not have a history of cancer or significant immune disorders.
• Casgevy should only be reimbursed if prescribed by a hematologist with expertise in SCD, if it is not a re-treatment (Casgevy is a one-time treatment), and if the cost of Casgevy is reduced.