Gene Therapies for Treatment of Wounds in Dystrophic Epidermolysis Bullosa

This policy covers gene therapies for treatment of cutaneous wounds in dystrophic epidermolysis bullosa (DEB), including FDA‑approved beremagene geperpavec‑svdt (Vyjuvek™) when policy clinical criteria are met, and certain adjunct HDE wound dressings. Coverage is limited to patients aged ≥6 months with a confirmed COL7A1 mutation and clinical DEB manifestations (chronic/recurring wounds, blistering or mucosal involvement); targeted wounds must have no active infection or active/prior squamous cell carcinoma, dosing/use must follow authoritative sources, and non‑FDA indications require support from accepted compendia or peer‑reviewed evidence and are subject to member benefit and state plan rules.

"Use of gene therapies to treat wounds in patients with dystrophic epidermolysis bullosa"

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