UnitedHealth reverses coverage denial for million-dollar gene therapy

UnitedHealthcare, the insurance arm of UnitedHealth Group, reversed its denials of a $2.1 million gene therapy for children, according to The Washington Post.

UnitedHealthcare initially denied coverage for Novartis' drug Zolgensma, a one-time treatment for spinal muscular atrophy, but has since approved coverage for all six requests it received for the new drug.

The advanced gene treatment was approved by the FDA in May for most children under age 2 with spinal muscular atrophy. Insurers have been reluctant to cover new gene treatments based on medical necessity.

UnitedHealth Group's CMO, Richard Migliori, MD, told The Washington Post the coverage reversals were based on clinical evidence, not on public attention generated by the denials.

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