Nusinersen (Spinraza)

Coverage: nusinersen (Spinraza) is covered for FDA‑approved treatment of spinal muscular atrophy (SMA) and is excluded for patients lacking required genetic confirmation or who have received onasemnogene abeparvovec (Zolgensma). Key requirements: documented bi‑allelic SMN1 mutation, SMN2 copy number of 2–3 (or ≥4 with clinical SMA Type 1–3 symptoms), pre‑administration labs (PT/aPTT, platelets, urine protein), prescription/consultation by an SMA/neuromuscular specialist, intrathecal dosing per the specified loading/maintenance schedule, initial approval 3 months and 4‑month renewals only with documented clinical response.

"FDA-approved indication: Spinraza is indicated for the treatment of spinal muscular atrophy (SMA)."

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