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Zolgensma, the Novartis gene therapy for infants and the world’s most expensive medicine, continues to perform well commercially, bringing in $186 million during the fourth quarter, topping analyst expectations on Wednesday.

Last June, Novartis secured U.S. approval for Zolgensma as a one-time treatment for spinal muscular atrophy, a rare and deadly neurological disease. It carries a record price tag of $2.1 million, or an annualized cost of $425,000 per year for five years.

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Novartis said Wednesday that approximately 200 patients have been treated with Zolgensma since the June launch, double the figure from the end of the September quarter. Sales in 2019 were $361 million. The company said reimbursement agreements are now in place with insurers to cover 97% of patients with commercial plans and 50% of patients covered by Medicaid.

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