Alzheimer's patients could pay roughly $75,000 each year for treatment and medical costs related to the IV drug aducanumab (sold under the brand name Aduhelm), according to new peer-reviewed analysis from the American Academy of Neurology.
Neurologist Dr. Andrew Budson reviewed the report and provided context to us.
"The drug itself is expensive, the diagnostic tests are expensive, and the surveillance MRI scans can be costly as well," Budson said.
The brain of an Alzheimer's patient has something called plaques, which are clumps of specific proteins that can bundle and disrupt communication between nerve cells and cause brain inflammation.
"The cells are what allows our brain to have different parts of it to talk to one another, which is what allows thinking and memory and talking and vision and all sorts of other activities," Budson said.
Aducanumab works by sticking antibodies to the plaques, allowing the body's immune system to come in and remove them.
The drug is given for 45 to 60 minutes every four weeks.
The analysis included direct costs a patient or their family member would pay. That $75,000 annual cost includes doctor's visits, neuropsychological testing, blood screenings, brain scans, the actual drug infusions, follow up visits and MRIs and travel.
NEWSY'S LINDSEY THEIS: Would you recommend or prescribe this medication?
ANDREW BUDSON: I would not recommend or prescribe this medication. And the reason is that side effects were very common. Approximately 30% of individuals had brain swelling.
Side effects like brain swelling, brain bleeds and even stroke did show up in the clinic trials for the drug. That's why costly scans and follow ups are so important.
Patients could reduce the number of follow-ups, the AAN notes, but that could mean risking detecting brain bleeds early.
"I've seen patients that have had 30, 40, 50 of these little, tiny bleeds related to the drug, related to the treatment," Budson said.
Right now, Medicare is initially covering the price of the new Alzheimer's drug with a more permanent decision expected in April, saying related costs would only be covered if an additional randomized clinical trial happens.
Biogen has countered with a real-world study instead, meaning patients would be evaluated as they receive treatment.
Most private insurers are still evaluating.
The American Academy of Neurology says more research needs to be done before it says yes or no to recommending aducanumab, leaving the choice to patients and those who care for them.
"If I compare the side effects of Alzheimer's to the side effects of this drug, I will take the drug any day," said Mike Zuendel, who receives the treatments.