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The FDA approved a new medicine Friday to reduce the complications associated with sickle cell disease, a rare blood disorder.

The drug, Endari, is made by privately held Emmaus Medical and is the first new treatment for sickle cell disease to secure FDA approval in almost 20 years. However, the active ingredient in Endari — L-glutamine — is an old chemical that can be purchased over the counter, which could complicate Emmaus’s ability to obtain insurance coverage.

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