# Keralam’s cheaper SMA drug switch sparks safety debate

2026-10-22T04:19:32+00:00 | Governance | Indian Opinion Desk

Corroboration: 2 independent outlets

A row over Keralam's decision to replace the branded SMA drug Evrysdi with Natco Pharma's generic version Natsmart, priced at Rs 15,900 per bottle against Evrysdi's Rs 6.2 lakh, escalated after bottles labelled 'Physician Sample' were distributed at SAT Hospital. Parents and opposition leaders, including former health minister KK Shailaja, alleged children were being given an 'experimental drug' and demanded evidence of safety. Hospital authorities said the generic version has CDSCO approval and that sample bottles were used only to cover a shortfall in supply until government stock arrived on Tuesday, 20 October. The UDF government says the switch, initiated under the previous LDF government in February 2026, will make treatment accessible to more of the 118 children receiving it free of cost.

## Indian Opinion Analysis

The coverage of Keralam's switch to a generic SMA drug splits largely along sourcing lines. thesouthfirst.com foregrounds the debate, leading with cost comparisons and citing opposition from parents and former minister KK Shailaja at length, while thehindu.com leads with expert dismissal of the row as unwarranted and emphasises official explanations from SAT Hospital and the Health Minister. The two outlets agree on the core facts, CDSCO approval, the ₹15,900 price, the generic manufacturer Natco, but differ in emphasis: thesouthfirst.com gives voice to safety concerns and the sample bottle controversy, while thehindu.com stresses that the generic is equivalent and the switch was initiated under the previous government. A balanced reading notes that both sides accept the drug's affordability, the unresolved question, left open by thesouthfirst.com's coverage, is whether completed bioequivalence studies exist to reassure parents.

## Coverage

Coverage: 2 sources, 1 pro-government, 1 sensationalist
- thesouthfirst.com (sensationalist) <https://thesouthfirst.com/keralam/from-rs-6-2-lakh-to-rs-15900-a-generic-drug-switch-sparks-safety-debate-in-keralam/>
  Leads with cost gap and parent opposition, gives Shailaja's criticism prominent space
- thehindu.com (pro government) <https://www.thehindu.com/news/national/kerala/row-over-sma-drug-distribution-in-keralam-unwarranted-say-experts/article71607610.ece>
  Leads with expert dismissal, foregrounds official clarifications and hospital statement

This brief was synthesised by AI from the 2 sources linked above, so one read covers every framing they carry.

Tags: CDSCO, Keralam, KK Shailaja, Natco Pharma, Roche, spinal muscular atrophy
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How this brief was made: an AI model read the reports linked above and wrote this summary and analysis, which were published automatically. Published briefs are sampled every hour by an automated quality check; the editor verifies its findings and approves corrections, and corrected briefs carry a dated correction line. Stance labels are editorial classifications of how each outlet framed this story, assigned by the same model, not ratings of the outlets. We do no original reporting. Methodology: https://indianopinion.org/ai-use-policy/