| Spinal Muscular Atrophy
Zolgensma vs Evrysdi
Side-by-side clinical, coverage, and cost comparison for spinal muscular atrophy.Deep comparison between: Zolgensma vs Evrysdi with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsEvrysdi has a higher rate of injection site reactions vs Zolgensma based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Evrysdi but not Zolgensma, including UnitedHealthcare
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Category
Zolgensma
Evrysdi
At A Glance
IV infusion
Single dose
AAV9-based gene therapy
Oral
Daily
SMN2 splicing modifier
Indications
- Spinal Muscular Atrophy
- Spinal Muscular Atrophy
Dosing
Spinal Muscular Atrophy Single IV infusion of 1.1 x 10^14 vg/kg body weight administered over 60 minutes; systemic corticosteroids (oral prednisolone 1 mg/kg/day) initiated one day prior to infusion and continued for 30 days, then tapered over 28 days or longer if liver function abnormalities persist.
Spinal Muscular Atrophy Once daily orally with or without food: <2 months 0.15 mg/kg; 2 months to <2 years 0.2 mg/kg; >=2 years weighing <20 kg 0.25 mg/kg; >=2 years weighing >=20 kg 5 mg (oral solution or tablet).
Contraindications
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Adverse Reactions
Most common (>=5%) elevated aminotransferases, vomiting
Postmarketing thrombotic microangiopathy, thrombocytopenia, acute liver failure, acute liver injury, pyrexia, infusion-related reactions, troponin increased
Most common (>=10%) - Later-onset SMA fever, diarrhea, rash
Most common (>=10%) - Infantile-onset SMA fever, diarrhea, rash, upper respiratory tract infection, lower respiratory tract infection, constipation, vomiting, cough
Pharmacology
Onasemnogene abeparvovec is a recombinant AAV9-based gene therapy designed to deliver a functional copy of the SMN1 gene, restoring SMN protein expression that is deficient in spinal muscular atrophy due to bi-allelic mutations in the SMN1 gene; intravenous administration results in cell transduction and expression of the SMN protein.
Risdiplam is an SMN2 splicing modifier that increases exon 7 inclusion in SMN2 mRNA transcripts, resulting in increased production of full-length SMN protein in the brain to treat spinal muscular atrophy caused by chromosome 5q mutations leading to SMN protein deficiency.
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Most Common Insurance
Anthem BCBS
Zolgensma
- Covered on 5 commercial plans
- PA (0/12) · Step Therapy (0/12) · Qty limit (0/12)
Evrysdi
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (0/12) · Qty limit (9/12)
UnitedHealthcare
Zolgensma
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Evrysdi
- Covered on 4 commercial plans
- PA (5/8) · Step Therapy (0/8) · Qty limit (5/8)
Humana
Zolgensma
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (1/3)
Evrysdi
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableGood Days: Spinal Muscular Atrophy
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
$0/fillfill
Evrysdi Co-pay ProgramCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.