Point32Health may not cover Biogen's new Alzheimer's treatment, Aduhelm, for its commercial members unless the price is reduced.
Point32Health CMO Michael Sherman, MD, told The Boston Globe that the drugmaker was favoring "excessive corporate profits" with the $56,000 price tag over patient interests. Dr. Sherman believes the price of the treatment should be closer to $5,600, 10 percent of the current cost.
While no coverage decisions have been made as of yet, Dr. Sherman said Point32Health has explored limiting coverage or tracking drug efficiency with patients should it be used.
The insurer, which was formed as a merger between Tufts Health Plan and Harvard Pilgrim Health care, serves 2.2 million members across New England, though 1.1 million are in government-funded programs like Medicare Advantage where coverage of the drug will depend on Medicare's determination.
Biogen has received widespread backlash over both the approval of Aduhelm and its pricing of the treatment.