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Ionis Pharma prices first FDA-approved treatment for Alexander disease at $285,000 per dose

By Thomson Reuters Sep 3, 2026 | 3:28 PM

By Siddhi Mahatole and Christy Santhosh

Sept 4 (Reuters) – Ionis Pharmaceuticals said on Friday it would price its newly approved therapy to treat Alexander disease at $285,000 ​per dose, a day after the U.S. FDA ‌cleared the injectable drug, making it the first approved treatment for the genetic disorder in adults and children.

Alexander disease is a rare neurodegenerative disorder that often starts in early childhood and damages ‌brain ​cells and causes problems with movement, ⁠speech and swallowing. It ⁠affects fewer than 1,000 people in the U.S., according to the National Institutes of Health.

Ionis expects peak sales for the therapy zilganersen, branded as Zanvastro, to exceed $100 ​million and said the drug will be available in the United States in the coming weeks.

In an ⁠early-to-late-stage study, Alexander disease patients who ⁠got a 50 mg dose of Zanvastro ​showed a statistically significant improvement in gait speed as assessed ​by a 10-meter walk test at 61 weeks.

Jenny ‌Pearson, whose daughter joined Ionis’ trial for Alexander disease, called the approval a “miracle” that offers families meaningful hope instead of being turned away.

Zanvastro is administered as an injection ⁠into the spinal canal every three months by a healthcare professional.

Oppenheimer analyst Jay Olson said the approval meaningfully de-risks Ionis’ broader ⁠neurology pipeline, including ‌obudanersen for Angelman syndrome, for which ⁠late-stage trial data are expected in the ​second half ‌of 2027.

“We don’t view the recent failure ​of Ultragenyx’s apazunersen ⁠in Angelman syndrome as negatively impacting the probability of success for obudanersen,” Olson added.

Ionis said it will continue to study Zanvastro in an open-label extension trial.

(Reporting by Christy Santhosh and Siddhi Mahatole in Bengaluru; Editing by Diti Pujara ​and Sahal Muhammed)