Morning Briefing
Summaries of health policy coverage from major news organizations
Medicare, Insurers Face Hefty Costs From Drug Price Set At $56,000 A Year
Stat: The Price Of Biogen's Alzheimer's Drug May Lead Payers To Erect Roadblocks
The Food and Drug Administration’s approval on Monday of an Alzheimer’s drug developed by Biogen is raising fresh questions about the financial implications for millions of families, insurers, and American taxpayers. But the drug maker is already scrambling to mitigate the fallout. At a wholesale price of $56,000 per year, the company exceeded some Wall Street expectations, and greatly surpassed the $8,300 threshold that a nonprofit determined was the price at which the medication could be considered cost-effective. That assessment reflected intense controversy over study data that prompted numerous experts to question the extent to which the drug actually helps patients. (Silverman, 6/7)
Reuters: U.S. Approval Of Biogen Alzheimer's Drug Sends Shares Soaring, Hailed As 'Big Day" For Patients
Biogen said it has priced the drug, to be sold as Aduhelm, at $56,000 per year. ... U.S. health insurers and the U.S. government's Medicare program will bear most of the cost of the drug, whose price will vary based on dosage and discounts. (Steenhuysen and Beasley, 6/7)
CNBC: Biogen CEO Says $56,000 Annually For Alzheimer’s Drug Is 'Fair,' Promises Not To Hike Price For At Least 4 Years
Biogen CEO Michel Vounatsos told CNBC on Monday that the list price of $56,000 per year for the company’s FDA-approved Alzheimer’s disease drug aducanumab is “fair.” That being said, the Massachusetts-based biotech company has vowed to not increase the price of the medication, which is marketed under the name Aduhelm, for the next four years, Vounatsos said. (Lovelace Jr., 6/7)
AP: How Will Insurers Cover A New Alzheimer's Drug?
[Insurers] will likely request some documentation first that the patient needs the drug. Many plans will require doctors to submit records and other paperwork justifying the treatment before they agree to cover it. Insurers also will likely require pre-approval for brain scans needed to determine that the patient is a candidate for treatment, said Lance Grady of Avalere Health consultants. (Murphy, 6/8)
Axios: Price Of Alzheimer's Drug Aduhelm To Squeeze Medicare And Patients
More than 90% of people with Alzheimer's disease are 65 and older, which means Medicare (i.e., taxpayers) will shoulder the load for Aduhelm's $56,000 annual list price. Aduhelm could create massive strains on Medicare spending and could create financially ruinous prospects for patients and their families. (Herman, 6/8)
In related news —
Stat: Despite High Price, New Alzheimer’s Drug Isn’t Reigniting Drug Pricing Debate
It has all the makings of a bombastic drug pricing debate: a highly anticipated drug, widespread press attention, a huge potential patient population, and a price higher than even some of the highest Wall Street estimates. But when Biogen announced Monday it would charge $56,000 for an annual course of its just-approved Alzheimer’s treatment, the activists who are normally eager to criticize pharma and its pricing strategies were largely silent. So, too, were progressives on Capitol Hill, many of whom who’ve decried high drug prices as a key campaign issue. (Florko, 6/8)
Stat: Why Biogen May Have The Most Lucrative Product In Pharmaceutical History
Biogen’s quest to win approval for a new Alzheimer’s disease treatment once seemed futile. Now the company is sitting on what could be the most lucrative product in pharmaceutical history. Hours after the Food and Drug Administration’s surprising approval of Aduhelm, the company’s controversial treatment for Alzheimer’s disease, Biogen set a list price that was nearly five times what Wall Street analysts had expected: $56,000 per year for the average patient. (Garde and Feuerstein, 6/7)
