Kerala switches spinal muscular atrophy patients from a Rs 6,20,835 bottle to a generic risdiplam priced at Rs 15,900

21 October 2026

Kerala has moved patients with spinal muscular atrophy from Evrysdi, the risdiplam made by Roche, to Natsmart, a generic risdiplam made by Natco Pharma. Evrysdi's open-market price is Rs 6,20,835 a bottle, while Natsmart costs Rs 15,900 a bottle, about 40 times cheaper. The government decided in July 2026 to procure the generic, and the Technical Committee on SMA noted that the Central Drugs Standard Control Organisation had approved it and that generics do not need separate safety and efficacy studies. Health Minister K Muraleedharan said the medicines are low cost and Indian made, were supplied after an expert committee found them to be of good quality, and that no complaints about them have been received. About 118 children receive free risdiplam. Public health expert B Ekbal estimated the monthly cost of the generic at about Rs 40,000. Parents and the Cure SMA Foundation of India have asked for Evrysdi to continue until bioequivalence evidence on the generic is available, and former Health Minister K K Shailaja said lower prices do not guarantee quality.