Spinraza® (nusinersen)

Spinraza is covered for pediatric and adult SMA patients with genetic confirmation of bi-allelic SMN1 pathogenic variants and either 2–3 SMN2 copies (or 4 SMN2 copies with symptoms), while prior Zolgensma recipients are excluded and concurrent Evrysdi is not permitted (Evrysdi must be discontinued). Coverage requires documentation of SMN2 copy number and a baseline motor assessment, prescription/consultation by an SMA/neuromuscular specialist, adherence to the intrathecal loading/maintenance dosing schedule (4 loading doses then maintenance every 4 months), initial approval for 3 months and renewals for 4 months with ≥4 months since last dose plus evidence of clinical response or ongoing benefit.

"Spinraza is indicated for the treatment of spinal muscular atrophy (SMA) in pediatric and adult patients."

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