Anthem Updates Insurance Policy for Spinraza

Anthem Inc. recently announced an updated insurance policy for the use of Spinraza (nusinersen) for treatment of spinal muscular atrophy. The revised policy expands criteria for treatment to onset of SMA-associated signs and symptoms before 21 months of age; the previous policy’s criteria for treatment of onset symptoms was 6 months or younger.

In 2016, Cure SMA initiated an insurance coverage and payment policy project. Through this project, we have advocated directly with key public, private, and state-based stakeholders to educate them on the need for access to, coverage for, and payment of SMA care and treatment.

With the first-ever approved therapy, this is a critical time for us to advocate on the topic of insurance and reimbursement, focusing on ensuring prompt, comprehensive coverage for all ages, stages and types of individuals affected by SMA. We commend Anthem for listening to our community’s advocacy, and expanding their policy for Spinraza. Through our coverage and payment policy project, we will continue to work with Anthem, other commercial insurers, and state Medicaid boards to press for coverage of all ages, types and stages of SMA.

In addition, our newest care series booklet, Choice and Connection to Care: A Health Insurance Roadmap for People Living with Spinal Muscular Atrophy (SMA) and Their Caregivers, is intended to help families address some of the most common issues and questions of insurance coverage and payment.

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