Is the newly approved Alzheimer's drug worth its hefty price tag?
Aduhelm comes with an annual patient cost of $56,000 and would cause a significant increase in drug spending, particularly for Medicare.
The U.S. Food and Drug Administration recently approved a new drug for treatment of Alzheimer’s disease, despite concerns about both the cost and efficacy.
Although Biogen, the manufacturer, tested Aduhelm on patients with mild cognitive impairment, the FDA approved its use more broadly for the more than six million Americans currently diagnosed with Alzheimer’s. The drug is administered through intravenous infusion at an annual cost of $56,000 per patient, a non-retail expenditure that will be borne primarily by Medicare Part B. Several researchers recently analyzed estimated expenditures on Aduhelm for Altarum, a nonprofit health care research and consulting organization.
Related: Snapshot: Is increased health care spending worth it?
“These estimates indicate that Aduhelm prescribing will result in a significant increase in expenditures for non-retail prescription drug spending, all prescription drug spending and the national health expenditure,” they said.
They compared the introduction of an expensive prescription drug to the launch of new drugs to treat hepatitis C nearly a decade ago. In 2013, retail prescription drug spending grew by only 2.2%, but in 2014, it jumped to 13.5%. However, by 2016, the growth rate had dropped to 1.7%, largely because these drugs are administered only once per patient.
By contrast, Aduhelm is to be administered repeatedly throughout the patient’s lifetime or until the patient and his or her physician elect to discontinue treatment. The resulting growth in spending therefore will be sustained for the foreseeable future.
However, the study said, an increase in health spending is not necessarily a bad thing if the added spending brings significant value. For example, the hepatitis C drugs, while costly, are a cure, improving the lives of those with the disease and offsetting at least some of the increased cost by reducing spending on future disease treatment. By contrast, the limited evidence for the efficacy of Aduhelm raises the question of whether its large impact on health spending is justified.
“Offering hope has value, but there are opportunity costs,” the researchers concluded. “Money spent on Aduhelm is money not available to spend on other care or supports for those with Alzheimer’s and their families. As Medicare will bear most of the cost, it is money not available to fund other types of health care, to fund federal government priorities outside of health care or to reduce the federal deficit.
“These tradeoffs are not new, but the size of the potential impact on spending that we and others have demonstrated is raising again issues around how our legal, regulatory and financing systems determine what we spend and the value we receive for our health-care spending.”
Read more: