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The downfall of Aduhelm, the first new treatment for Alzheimer’s disease in two decades, is largely the story of a drug company choosing to maximize its potential profits at the expense of patients and taxpayers, according to a congressional investigation that cites thousands of pages of internal Biogen documents.

More than a year before Aduhelm’s June 2021 approval, Biogen surveyed insurance companies and doctors about how much the Alzheimer’s treatment should cost. The resulting recommendations were clear: To make Aduhelm available to the largest number of patients, Biogen should charge no more than $20,000 per year. Any price above $35,000 would outstrip the value of a drug with uncertain benefits for patients and risk alienating physicians and pushing insurers to block access to the drug.


Biogen, facing challenges to its business, had other priorities. The company set a price of $56,000, planning to “establish Aduhelm as one of the top pharmaceutical launches of all time,” according to an internal presentation executives made to Biogen’s board in September 2020. “Our ambition is to make history,” the presentation reads, promising the drug would be a “blockbuster within 12 months.”

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