The Food and Drug Administration’s approval on Monday of an Alzheimer’s drug developed by Biogen (BIIB) is raising fresh questions about the financial implications for millions of families, insurers, and American taxpayers. But the drug maker is already scrambling to mitigate the fallout.
At a wholesale price of $56,000 per year, the company exceeded some Wall Street expectations, and greatly surpassed the $8,300 threshold that a nonprofit determined was the price at which the medication could be considered cost-effective. That assessment reflected intense controversy over study data that prompted numerous experts to question the extent to which the drug actually helps patients.
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Your final paragraph seems right on. This decision to price high will set off a cascade of efforts to restrict access, just like Hepatitis C drugs, and will be bellows to the flame over Medicare price negotiations for covered drugs, a controversy that was already rekindled. Expect congressional hearings and intense public scrutiny. CMS and private payers are now the fire brigade.