Kebilidi (eladocagene exuparvovec-tneq) - MEDICAID - VIRGINIA

This policy covers Kebilidi (eladocagene exuparvovec‑tneq), a gene therapy administered as four intraputaminal infusions in a single stereotactic neurosurgical procedure for treatment of aromatic L‑amino acid decarboxylase (AADC) deficiency due to biallelic DDC mutations (per FDA labeling and cited literature for pediatric and adult patients). Coverage is limited to a single one‑time lifetime dose and requires plan eligibility and compliance with FDA prescribing criteria (including confirmed DDC mutations); exclusions/contraindications noted include pregnancy/breastfeeding, reproductive intent/unwillingness to use contraception, lack of skull maturity, and prior authorization via Humana’s transplant department.

"Confirmation of AADC deficiency due to biallelic mutations in the DDC gene ${ }^{1,3,7}"

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