Amid row, Keralam’s UDF govt says cost of generic SMA drug can be cut further

Spinal Muscular Atrophy (SMA) is a rare, life-threatening genetic disorder that progressively weakens muscles, severely impairing mobility and respiratory function. Keralam was the first state to provide the drug Risdiplam, marketed as Evrysdi, free of cost to eligible children since 2022. However, a controversy has erupted after the government switched to a less expensive generic version, Natsmart, in October 2025.

Parents of children with SMA are demanding that the government revert to the branded drug, citing concerns about the safety and efficacy of the generic alternative. They argue that the branded medication has a proven track record of success, while the generic version lacks sufficient clinical studies specific to pediatric patients. Additionally, some parents claim that the switch to the generic drug could reverse the critical motor and survival progress already achieved by their children on the original drug.

The Keralam government maintains that the switch to the generic drug is necessary due to its significantly lower cost. The branded drug, Evrysdi, costs around ₹6.3 lakh per bottle, while the generic alternative, Natsmart, priced at ₹15,900 per bottle, could reduce the annual maintenance cost for a patient to under ₹5 lakh. The government has allocated ₹30 crore in the state budget to cover the cost of the generic drug for SMA patients.