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Zolgensma is one on the list that was approved earlier in the US than in Europe, requiring parents to fundraise during the gap period. Regarding absolute numbers, there are more SMA cases in the US than the UK. This is due to the overall population difference as well as a larger number of disproportionately affected populations which contributes to a higher rate of incidence. Zolgensma is authorized for treatment and payment using a similar review process and set of criteria in both countries. This is the case for both private/employer insurance coverage and pediatric public health programs. So I would take that bet.

Generally speaking, the US insurance system handles catastrophically expensive cases well. It’s the smallish cases (broken legs, etc) that are burdensome as copays leave families on the hook for several hundred to a few thousand dollars after insurance pays its contribution.