How much coverage will Medicaid provide for Aduhelm?

The Kaiser Family Foundation estimates that Aduhelm will inflict significant costs on Medicaid as it covers the Alzheimer's treatment. 

In a July 13 report, the foundation claimed that with a 23.1 percent rebate, Aduhelm would be priced at $43,000 per year, meaning that state spending per enrollee would be about $13,800. Costs could fluctuate with price increases compared to inflation and payer discounts. 

Despite the majority of Alzheimer's patients being Medicare beneficiaries, the report said the treatment's rollout could strain Medicaid drug spending. Much of that strain comes from its high-cost maintenance and potential wide use. 

The foundation estimated that if 25 percent of the 67,000 Medicaid beneficiaries that use Alzheimer's drugs switched to Aduhelm, the post-rebate cost would be near $720 million annually. A jump to 75 percent of beneficiaries using Aduhelm would swell net costs to nearly $2 billion, or 7 percent of Medicaid drug spending.

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