Why so few patients have gotten Biogen's new Alzheimer's treatment

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Despite Biogen's Alzheimer's drug Aduhelm being the first new Alzheimer's treatment in 18 years and the first to address the cause of the disease rather than its symptoms, it hasn't been given to many patients. The drug's high cost, lack of coverage by insurers and questions about how well it actually works have all contributed to the lack of usage, NPR reported Nov. 8. 

Aduhelm is indicated for people in the early stages of Alzheimer's disease, who make up about a quarter of the 6 million people in the U.S. with the disease, according to NPR

Biogen said in late October that since it was approved in June, Aduhelm has brought in $300,000 in sales, at a price of $56,000 per year, much less than many analysts expected, NPR reported. 

One reason for the slow rollout is likely the fact that many insurers haven't agreed to cover the drug. Medicare is expected to decide whether to cover the drug sometime next year, and private insurers seem to be waiting for its decision before deciding for themselves, according to NPR. That means in the meantime, many people would have to pay out of pocket for the drug. 

"I'm just not aware of that many people who could shell out $56,000 right now," Mia Yang, MD, a Alzheimer's and dementia physician at Atrium Health Wake Forest Baptist in Winston-Salem, N.C., told NPR

Dr. Yang told NPR that none of her patients have asked to take the drug once she explains to them the potential benefits and side effects. Aduhelm comes with a risk of some severe side effects, such as cerebral hemorrhage and swelling. 

The drug's unclear results have also confused some patients and may be contributing to slow sales, NPR reported. One clinical trial showed the drug was modestly effective at clearing a brain plaque that scientists believe is a cause of cognitive decline in Alzheimer's patients, while another trial showed no improvement. 

Some health centers, including Cleveland Clinic, Mount Sinai in New York City and Massachusetts General Hospital in Boston, have said they won't prescribe Aduhelm until clearer results are released. 

Rajesh Tampi, MD, a geriatric psychiatrist at Cleveland Clinic, told NPR that many patients may be too focused on the COVID-19 pandemic at the moment to seek treatment for Alzheimer's. 

"The pandemic has taken a toll on people, so the majority who are coming are mainly looking for relief from depression and anxiety and sleep problems. And I think the cognitive issues are less important," he said. 

Read the full article here.

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