Vertex Pharmaceuticals and CRISPR Therapeutics are projecting significant growth for their joint gene therapy, Casgevy, in 2026. The companies expect combined revenue from Casgevy and the new pain medication Journavx to reach $500 million, which would represent a 185% increase over previous figures.
This outlook marks a shift for Casgevy, which initially faced slow patient uptake after its approval. For more than six months post-approval, no patients had received the therapy. However, recent reports indicate an uptick in patient infusions and expanding insurance coverage.
During Vertex’s fourth quarter earnings call, Chief Operating Officer and Chief Financial Officer Charles Wagner said, “We do feel very confident about that number and have great line of sight to the year. With Casgevy, we had a strong year with 300 or so patients initiating—150 or so having first cell collections. And given the length of the patient journey, that gives us great visibility into the year. So we’re very confident that Casgevy will ramp up nicely compared to 2025.”
In the fourth quarter of 2025, Casgevy generated $54.8 million in revenue for both partners, surpassing consensus expectations of $38 million. For all of 2025, total earnings reached $115.8 million; this is a substantial increase from $10 million in 2024 when it was first approved for sickle cell disease in December 2023.
Duncan McKechnie, Vertex’s chief commercial officer, commented on this progress: “We successfully moved from a foundational year in 2024 to a year of building significant momentum in 2025.”
Analysts at William Blair estimate that Casgevy could earn $344 million in 2026, with CRISPR receiving $132 million and Vertex taking $212 million.
Patient access has also improved. In 2025 alone, there were 111 new patients starting infusions—almost three times as many as in 2024—with numbers including initial cell collections and edited cell transfusions. Approximately 90% of U.S. patients now have reimbursed insurance access to treatment. Internationally, Casgevy is covered in ten countries outside the U.S., including Scotland following its approval there for beta thalassemia in 2025.
Vertex plans to seek label expansion for Casgevy to include children aged five to eleven during the first half of the year. CEO Reshma Kewalramani noted that they received a Commissioner’s National Priority Review Voucher for Casgevy and anticipate an expedited review process.
The company recently presented Phase 3 data at the American Society for Hematology conference showing efficacy in young pediatric patients with sickle cell disease and beta thalassemia.
Despite these gains, executives cautioned about ongoing revenue variability due to factors such as patient decisions on when to receive infusions and delays between treatment initiation and infusion completion. McKechnie stated: “We anticipate this will smooth out in 2027 and beyond as the number of patients at all stages of the treatment journey continues to build.”
CRISPR CEO Samarth Kulkarni echoed optimism at January’s J.P. Morgan Healthcare Conference: “We’re very happy that we’ve reached the goal of over $100 million in revenue,” she said. ”The revenues are ramping up, and we feel very bullish about Casgevy and its trajectory. And we want the momentum to continue in ’26.”
