Nusinersen (Spinraza)

Spinraza (nusinersen) is covered for pediatric and adult SMA patients only for SMA type I or II with genetic confirmation of SMN1 homozygous deletion/mutation or compound heterozygous mutation (no off‑label compendial uses covered). Initial approval requires documented baseline motor milestones and FDA‑approved indication/safety criteria; reauthorization requires objective clinical response (improvement, maintenance, or new motor milestones), with approvals issued for 12 months.

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

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