Senator Ron Wyden Calls $56K-a-Year Price of New Alzheimer's Drug 'Unconscionable'

Aduhelm, an Alzheimer's treatment drug approved by the Food and Drug Administration (FDA) this week, would cost $56,000 annually and raise Medicare premiums, according to a research report from the nonpartisan Kaiser Family Foundation.

Senate Finance Committee Chairman Ron Wyden (D-OR) called the price of the drug "unconscionable."

"It's unconscionable to ask seniors and taxpayers to pay $56,000 a year for a drug that has yet to be proven effective," Wyden tweeted Tuesday. "Medicare must be able to negotiate a fair price for prescription drugs."

It's unconscionable to ask seniors and taxpayers to pay $56,000 a year for a drug that has yet to be proven effective. Medicare must be able to negotiate a fair price for prescription drugs. https://t.co/MTjGHcXEs8

— Ron Wyden (@RonWyden) June 8, 2021

The Kaiser analysis concluded that the approval of Aduhelm "provides the latest high-profile example of the potential budgetary consequences of Medicare's role as a price-taker in the pharmaceutical marketplace."

Ron Wyden Alzheimer's Drug Price
Sen. Chairman Ron Wyden (D-OR) questions Internal Revenue Service (IRS) Commissioner Charles Rettig during a Senate Finance Committee hearing June 8, 2021 on Capitol Hill in Washington, D.C. Wyden called the $56,000 price of Aduhelm Alzheimer's drug "unconscionable." Tom Williams/Getty Images

For more reporting from the Associated Press, see below:

Wednesday's analysis comes as congressional Democrats are trying to build consensus around legislation that would empower Medicare to negotiate prescription drug prices.

The Kaiser report estimated that if just 500,000 Medicare recipients are prescribed Aduhelm, it would cost the program nearly $29 billion a year, far more than any other medication.

"At this price, the cost of this one drug alone could top all others covered by Medicare, if it is used widely," said Tricia Neuman, coauthor of the report.

Medicare has not made a formal determination on covering Aduhelm, but cost traditionally does not enter into such considerations. Drugmaker Biogen has said it priced Aduhelm responsibly.

In addition to higher taxpayer costs, the domino effects would include higher "Part B" premiums for Medicare's outpatient coverage and increases in monthly premiums for millions with supplemental "Medigap" plans. As an infusion drug that would be administered in a doctor's office, Aduhelm is covered by Medicare's outpatient care benefit. The Part B standard premium, paid by most enrollees, is currently $148.50 a month.

Beyond monthly premiums, there would also be impacts on out-of-pocket costs. Many patients taking the medication, including those signed up in Medicare Advantage plans from private insurers, could face thousands of dollars in copayments. The maximum could reach about $11,500, researchers estimated.

That upper-bound cost out of patients' budgets would translate to nearly 40% of the $29,650 estimated median income for Medicare beneficiaries.

"Because Aduhelm is not a cure for Alzheimer's disease, patients could incur these annual out-of-pocket costs over multiple years," the report noted.

Biogen, which developed the Alzheimer's drug with Japan's Eisai Co., said earlier this week that it expects a gradual uptake and not a sharp "hockey-stick" spike.

Biogen priced the drug after careful research, said Chirfi Guindo, Biogen's head of global product. Biogen has committed to no price increases for four years.

Guindo said that the company looked at prices for advanced medications to treat cancer and other complex conditions. "We have priced Aduhelm at roughly a third the level of the cancer immunotherapies," he said during a teleconference this week. "So, we consider this to be a really responsible price and we consider this to be a price that is sustainable for the system."

Medicare has a review process known as a National Coverage Determination to evaluate new treatments that could have far-reaching implications for the program. Officials have not yet said how the program will proceed with Aduhelm. It's possible Medicare could set conditions for covering the drug, based on clinical effectiveness.

The program covers more than 60 million people, including those 65 and older, as well as people who are disabled or have serious kidney disease. Medicare spending is approaching $1 trillion a year.

Aduhelm Drug Price
This image provided by Biogen on Monday, June 7, 2021 shows a vial and packaging for the drug Aduhelm. Senate Finance Committee chairman Ron Wyden (D-OR) called the price of the drug “unconscionable.” Biogen via AP