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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.

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