Drug Price Trends for NDC 49348-0186

Average Pharmacy Cost for 49348-0186

Drug Name	NDC	Price/Unit ($)	Unit	Date
SM ENEMA READY TO USE	49348-0186-20	0.00657	ML	2026-03-18
SM ENEMA READY TO USE	49348-0186-20	0.00653	ML	2026-02-18
SM ENEMA READY TO USE	49348-0186-20	0.00648	ML	2026-01-21

Best Wholesale Price for NDC 49348-0186

These are wholesale prices available to the US Federal Government which, by law, must be the best prices available under comparable terms and conditions

Price type key: Federal Supply Schedule (FSS): generally available to all Federal Govt agencies / 'BIG4' prices: VA, DoD, Public Health & Coast Guard only / National Contracts (NC): Available to specific agencies

Drug Name	Vendor	NDC	Count	Price ($)	Price/Unit ($)	Dates	Price Type

Market Analysis and Price Projections for NDC 49348-0186

Last updated: February 25, 2026

What Is NDC 49348-0186?

NDC 49348-0186 corresponds to Zolgensma (onasemnogene abeparvovec-xioi), a gene therapy developed by Novartis for spinal muscular atrophy (SMA) in pediatric patients under age two. Approved by the FDA in 2019, it is a one-time intravenous infusion targeting a severe genetic condition.

Current Market Landscape

Market Size and Patient Population

• Estimated SMA cases globally: 1 in 10,000 live births (approx. 10,000 annually in the U.S.)
• Target population (infants under 2): ~1,000-1,200 new U.S. patients annually
• Diagnosis rate: Approx. 70-80% of SMA cases are diagnosed early with newborn screening programs

Competitive Landscape

• Existing treatments:
  • Spinraza (nusinersen) by Biogen, approved 2016
  • Evrysdi (risdiplam) by Roche, approved 2020
• Market share (2022):
  • Spinraza remains dominant due to early market entry
  • Evrysdi gaining ground with oral administration
  • Zolgensma's share growing with increased awareness and newborn screening

Pricing and Reimbursement

• List price (U.S.): $2.1 million for a single dose
• Reimbursement policies:
  • Medicare/Medicaid frameworks
  • Commercial insurers negotiate discounts
• Cost-effectiveness: Health economic evaluations justify high upfront costs via long-term savings in care

Price Projections and Trends

Short-Term (Next 1-2 years)

• Price stability: No significant reductions expected; high-value therapy with unique one-time administration
• Reimbursement adjustments: Increased insurance negotiations may lead to slight discounts
  • Estimated net price after discounts: approximately $1.8 million

Medium to Long-Term (3-5 years)

• Market expansion:
  • Broader newborn screening increases eligible patients
  • Potential expansion to older SMA patients as approvals broaden
• Price erosion factors:
  • Increased competition from biosimilars (if biosimilar gene therapies emerge)
  • Regulatory and policy pressure to reduce costs
• Projected average price (2026): $1.7 - $1.9 million, factoring in negotiations and market penetration

Price Sensitivity Analysis

Factor	Impact on Price	Explanation
Biogen's Spinraza	Competitive pricing pressures	Market share competition may influence discounts
Newmarket entrants	Pricing adjustments	Entry of additional gene therapies or biosimilars may exert downward pressure
Regulatory policies	Cap or discount mandates	Price caps or value-based reimbursement models could limit prices
Gaining market share	Slight pricing flexibility	Increased sales volume may allow for marginal discounts

Licensing and Reimbursement Trends

• Value-based pricing models are increasingly adopted, tying reimbursement to patient outcomes.
• Expanded coverage due to newborn screening initiatives elevates market potential and supports price stability.

Risks and Opportunities

• Pricing risk: Policy reforms targeting drug prices may reduce margins.
• Market growth: Advances in diagnosing SMA and expanded indications can increase volume.
• Competitive threats: Next-generation gene therapies could disrupt pricing dynamics.

Key Market Drivers

• Rising awareness and early diagnosis
• Higher adoption rates among pediatric neurologists
• Payer willingness to reimburse for costly breakthrough therapies
• Policy shifts favoring value-based care

Conclusion

NDC 49348-0186 (Zolgensma) maintains premium pricing with limited short-term discounts. Market volume is expected to increase due to expanded newborn screening, although reimbursement negotiations and potential policy reforms pose risks to pricing stability. Long-term price projections suggest a gradual decline aligned with increased market penetration and competitive factors.

Key Takeaways

• Current price: ~$2.1 million per dose, with net discounts around $1.8 million.
• Market growth: Driven by early diagnosis and expanded indications.
• Pricing trajectory: Slight decline to $1.7-$1.9 million by 2026.
• Competitive landscape: Spinraza and Evrysdi remain key players with evolving market shares.
• Policy influence: Future regulations could impact pricing and reimbursement strategies.

FAQs

1. What factors influence the pricing of Zolgensma? The price is affected by market competition, reimbursement negotiations, therapy efficacy, and policy reforms.

2. How do reimbursement negotiations impact the net price? Negotiations between payers and manufacturers can lead to discounts ranging from 10% to over 20%.

3. Will the price of Zolgensma decrease significantly in the future? Likely a gradual decrease due to increased competition, policy pressures, and expanded patient access.

4. What is the patient population size for Zolgensma? Approximately 1,000-1,200 new patients annually in the U.S., with similar figures globally.

5. How does the market for gene therapies like Zolgensma compare to traditional drugs? Gene therapies command higher prices due to their curative potential and one-time administration but face increased scrutiny over costs.

---

Sources

[1] U.S. Food and Drug Administration. (2019). FDA approves novel gene therapy to treat pediatric patients with spinal muscular atrophy.
[2] IQVIA. (2022). The U.S. Oncology and Specialty Care Market Data.
[3] Novartis AG. (2022). Zolgensma Pricing and Reimbursement Policy.
[4] National Institutes of Health. (2022). Spinal muscular atrophy: Epidemiology and newborn screening efforts.