With the first therapy north of $1 million gaining FDA approval last month, payers likely will implement a variety of strategies to manage Zolgensma (onasemnogene abeparvovec-xioi), a one-time gene therapy from AveXis, Inc., a Novartis company (see story, p. 1). Among those is likely to be some kind of approach addressing whether members receiving the new therapy may continue on another expensive therapy for spinal muscular atrophy (SMA), Spinraza (nusinersen). For now, though, many uncertainties exist with respect to the new treatment and what its place will be in SMA care.
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