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The controversial new Alzheimer’s drug from Biogen (BIIB) would be cost-effective only if priced between $3,000 and $8,400, which represents an 85% to 95% discount off the $56,000 list price, due to “insufficient” evidence the drug benefits patients, according to a revised analysis.

The assessment is very similar to an evaluation that was issued last month, before the Food and Drug Administration approved the medicine and issued a broad label. This means the medication can be prescribed to potentially millions of patients, regardless of the extent of their disease, even though Biogen tested its drug only on people with mild cognitive impairment to mild Alzheimer’s.

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However, the company has pledged to promote the drug only to that specific patient population and the FDA is requiring fewer costly MRI scans to monitor patient safety — specifically, the possibility of microscopic hemorrhages in the brain. As a result, the cost-effectiveness estimates increased slightly from between $2,500 and $8,300 a year, although the same overall concerns remain.

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