| Spinal Muscular Atrophy
Zolgensma vs Spinraza
Side-by-side clinical, coverage, and cost comparison for spinal muscular atrophy.Deep comparison between: Zolgensma vs Spinraza 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 signalsSpinraza has a higher rate of injection site reactions vs Zolgensma based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Spinraza but not Zolgensma, including UnitedHealthcare
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Category
Zolgensma
Spinraza
At A Glance
IV infusion
Single dose
AAV9-based gene therapy
Intrathecal injection
Every 4 months (maintenance)
Antisense oligonucleotide (ASO)
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 - Low Dose Regimen Loading: 12 mg intrathecally every 14 days for 3 doses, then a fourth 12 mg dose 30 days after the third; maintenance: 12 mg once every 4 months.
Spinal Muscular Atrophy - High Dose Regimen Loading: 50 mg intrathecally followed by a second 50 mg dose 14 days later; maintenance: 28 mg once every 4 months.
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 (>=20%) Lower respiratory infection, constipation (infantile-onset SMA); pyrexia, headache, vomiting, back pain (later-onset SMA)
Serious Thrombocytopenia, coagulation abnormalities, renal toxicity, atelectasis
Postmarketing Meningitis, hydrocephalus, aseptic meningitis, angioedema, urticaria, rash, arachnoiditis
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.
Antisense oligonucleotide (ASO) that increases exon 7 inclusion in SMN2 mRNA transcripts, restoring production of full-length SMN protein to treat SMA 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)
Spinraza
- Covered on 5 commercial plans
- PA (2/12) · Step Therapy (0/12) · Qty limit (0/12)
UnitedHealthcare
Zolgensma
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Spinraza
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Zolgensma
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (1/3)
Spinraza
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (0/3) · Qty limit (0/3)
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
Biogen $0 Drug/Procedure Copay Program: SpinrazaCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.