An Indian court has cleared the way for low-cost alternatives to Roche’s drug Evrysdi for spinal muscular atrophy. What’s behind the decision and what could it mean for rare disease patients everywhere? On October 9 the Delhi High Court refused to issue Roche an injunction to prevent generic manufacturers from making and selling a low-cost version of one of the company’s top selling drugs. The drug risdiplam, sold by the Swiss pharma giant as Evrysdi, was first approved in the US in 2020 for the treatment of spinal muscular atrophy – a genetic disease that leads to muscle loss and wasting. Babies with the most serious form of the disease often don’t live past their second birthday. What does the Delhi court’s ruling mean for patients in India and beyond? Alpana Sharma, the founder of the patient advocacy group Cure SMA Foundation India, told Swissinfo via email that the court’s “move has the potential to significantly improve access to affordable treatment options for SMA patients …