What is Spinraza?

The FDA announced the approval of Spinraza in December of 2016. It has been approved to treat both children and adults.  Spinraza is the first and only treatment approved in the U.S. for spinal muscular atrophy (SMA).  Spinal muscular atrophy is a genetic disease that causes weakness and muscle loss by affecting the motor nerve cells in the spinal cord.  Spinraza is administered intrathecally, which means it is injected into the fluid surrounding the spinal cord.  Additionally, the manufacturer recommends the drug be administered under sedation and with ultrasound or other imaging techniques to guide the administration.

What is the cost of Spinraza?

The total cost for year one of Spinraza is $750,000 (6 doses at $125,000 per dose).  After that, the total cost per year for Spinraza is $375,000 (3 doses at $125,000 per dose).  Additionally, patients are expected to remain on Spinraza throughout their lifetime.

Spinraza formulary coverage

Given the high cost and complex administration requirements, Spinraza is a specialty product that is is often times managed under the medical benefit.  If Spinraza is covered under the pharmacy benefit it will most likely have very strict prior authorization criteria.  Additionally, there are often times strict requirements related to continuation of therapy.  Spinraza formulary coverage under the pharmacy benefit varies greatly from plan to plan.  Check with your health plan and/or pharmacy benefit manager to determine Spinraza formulary coverage for your plan.