Vertex and CRISPR Project Nearly 3× Growth for Casgevy in 2026 as Patient Access Expands

February 13, 2026-Following a slower-than-expected commercial launch, Vertex Pharmaceuticals and CRISPR Therapeutics expect revenues from their jointly developed gene therapy Casgevy to nearly triple in 2026, driven by expanding patient access, increasing infusion volumes, and broader insurance coverage.

Casgevy, a CRISPR-based gene-editing therapy approved for sickle cell disease (SCD) and transfusion-dependent beta thalassemia (TDT), generated $115.8 million in revenue in 2025, including $54.8 million in the fourth quarter alone—exceeding analyst expectations of $38 million. By comparison, the therapy brought in $10 million in 2024, its first full year on the market following initial approval in December 2023.

For 2026, Vertex projects $500 million in combined revenue from Casgevy and its newly approved non-opioid pain therapy Journavx, representing a 185% increase year-over-year.

Company executives attribute confidence in the forecast to growing patient momentum. Approximately 300 patients initiated the treatment process in 2025, with about 150 undergoing initial cell collections. Given the lengthy autologous gene-editing workflow—spanning cell collection, ex vivo editing, conditioning, and reinfusion—these early-stage patients provide visibility into 2026 revenue realization.

Insurance access has also improved substantially. Approximately 90% of eligible U.S. patients now have reimbursed coverage, and Casgevy is approved in 10 countries outside the United States, including Scotland for beta thalassemia. Additional European and Middle Eastern markets are also contributing to patient flow.

Vertex plans to file for label expansion into pediatric patients aged 5 to 11 in the first half of 2026, supported by Phase 3 data presented at the 2025 American Society of Hematology meeting demonstrating efficacy in younger sickle cell and beta thalassemia patients.

Despite growing momentum, executives acknowledged continued quarter-to-quarter revenue variability due to the extended patient treatment journey and the timing of cell infusions, which trigger revenue recognition. The company expects revenue patterns to stabilize in 2027 as the treatment pipeline matures.

Analysts view Casgevy as reaching an inflection point, signaling that complex gene therapies may gradually overcome early commercialization hurdles as reimbursement frameworks, infrastructure, and physician confidence evolve.