Nusinersen (Spinraza®)

Covers nusinersen (Spinraza) for SMA patients with confirmed bi‑allelic SMN1 mutations who meet SMN2 criteria (2–3 copies, or ≥4 copies with symptomatic Types 1–3), given intrathecally at 12 mg (four loading doses then every 4 months maintenance); excluded if patient received onasemnogene abeparvovec (Zolgensma) and prior Evrysdi (risdiplam) must be discontinued. Key requirements: prescription by or consultation with an SMA/neuromuscular specialist, documentation of genetic testing and SMN2 copy number, pre‑dose labs (PT/APTT, platelet count, quantitative spot urine protein), initial approval 3 months with 4‑month renewals (one maintenance dose), and reauthorization requires evidence of clinical response.

"Has 2 or 3 survival motor neuron 2 (SMN2) gene copies OR has 4 or more SMN2 gene copies with symptoms consistent with Types 1, 2, or 3 SMA;"

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