Costly New Alzheimer's Drug Could Force Medicare to Restrict Access
Biogen's recently approved Alzheimer's drug, Aduhelm, sanctioned despite opposition from Food and Drug Administration (FDA) advisers, is so expensive that Medicare could restrict access to it. Critics already say there is no justification for such a steep cost—listed at $56,000 per year per patient, with annual sales into the billions—for a treatment that failed to demonstrate clear efficacy. Moreover, the bulk of the financial burden will fall to Medicare, which covers most patients who develop Alzheimer's disease. Former U.S. health officials and health-policy experts say the government health plan cannot feasibly cover everyone who might want the infused drug. FDA cleared Aduhelm for all patients with the Alzheimer's, rather than just those with early-stage disease, whom Biogen had studied in clinical trials. The exorbitant cost of the drug, coupled with the lack of consensus in the medical community, could lean FDA in the direction of "limiting access only to certain patients," agreed Anand Shah, a former senior official with Medicare and FDA. Private insurers that administer Part D benefits also might limit the drug's use, with access varying by region or insurer.
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