Nusinersen (Spinraza®)

Covered: Spinraza is authorized for SMA when genetic testing documents bi-allelic SMN1 mutations (homozygous deletion/mutation or compound heterozygote); patients with 2–3 SMN2 copies qualify and those with ≥4 copies qualify only if symptomatic (Types 1–3); prior treatment with Zolgensma excludes coverage and Evrysdi must be discontinued if used. Key requirements: baseline motor assessment by a listed tool (BSID‑III, CHOP‑INTEND, HFMSE, HINE‑2, MFM‑32, RULM, or WHO milestones), prescription/consultation by an SMA/neuromuscular specialist, pre-dose labs (PT/aPTT, platelet count, urine protein), intrathecal 12 mg dosing per loading/maintenance schedule, and documentation at reauthorization (≥4 months since last dose) of clinical improvement or ongoing benefit; initial approval 3 months, renewals 4 months.

"Spinraza is indicated for the treatment of spinal muscular atrophy (SMA)."