Zolgensma came to the market last year as the highest priced drug in the world. This gene therapy costs $2.1 million for a single-dose and it is considered a one-time, long-term treatment for the rare, genetic disease called spinal muscular atrophy (SMA).
The FDA has now approved a new treatment for SMA called Evrysdi. This drug is the first oral medication for SMA and it is taken once a day at home. Evrysdi comes with a price tag that ranges from $100,000 to $340,000 per year depending on weight.
Evrysdi is now the 3rd treatment option for SMA patients, and while it has a lower annual cost than both Zolgensma and Spinraza, it still poses a financial challenge for payers. For comparison, Spinraza is priced at $750,000 in the first year and then $375,000 each following year.
Since Evrysdi is self-administered at home, claims will be processed and paid through the pharmacy benefit rather than the medical benefit for carved-out plans. Reach out to Truveris to review your PBM plan design and ensure appropriate cost management is in place.