October 7, 2019
Dear members of the SMA community,
As part of our promise and commitment to keep the Canadian SMA community apprised of important
milestones regarding SPINRAZA™, we are sharing an update on recent developments regarding
reimbursement in the province of Nova Scotia. Effective October 1, 2019, the Government of Nova Scotia has
expanded access to this important therapy as part of the Nova Scotia Formulary Update.
Biogen Canada welcomes this news from the Nova Scotia government. It is a major milestone for the SMA
community which now allows patients who have been diagnosed with this rare condition and who meet the
criteria to be eligible for reimbursement.
Patients in Nova Scotia who are diagnosed with 5q SMA under the care of a specialist with experience in the
diagnosis and management of SMA, will now be eligible for reimbursement of SPINRAZA™ if the following
criteria are met:
1. Genetic documentation of 5q SMA homozygous gene deletion, homozygous mutation, or compound
2. Patients who:
• Are pre-symptomatic with two or three copies of SMN2, OR
• Have had disease duration of less than six months, two copies of SMN2, and symptom onset
after the first week after birth and on or before seven months of age, OR
• Are under the age of 18 with symptom onset after six months of age, AND
3. Patient is not currently requiring permanent invasive ventilationƗ
4. A baseline assessment using an age-appropriate scale (the Hammersmith Infant Neurological
Examination [HINE] Section 1, Children’s Hospital of Philadelphia Infant Test of Neuromuscular
Disorders [CHOP INTEND], or Hammersmith Functional Motor Scale-Expanded [HFMSE]) must be
completed prior to initiation of nusinersen treatment.
Other patients with SMA type 2 or 3 who are over the age of 18 may be considered on a case by case basis.
Nova Scotia now joins several other provinces that have expanded access to SPINRAZA™ and we are hopeful
that British Columbia, Manitoba and Newfoundland & Labrador follow this lead to ensure SMA patients across
Canada also have equal access.
Treatment access for pre-symptomatic SMA patients is an important step forward and a critical step towards
the implementation of a Maritime newborn screening program. Biogen believes that all SMA patients should
have broad access and we will continue to work with all jurisdictions until this is achieved in Canada.
ƗPermanent invasive ventilation is defined as the use of a tracheostomy and a ventilator due to progression of
SMA that is not due to an identifiable and reversible cause.