Medicare beneficiaries could face high out-of-pocket costs to access aducanumab, a new drug the FDA approved June 7 to treat Alzheimer's disease.
Biogen and its development partner Eisai estimate that the drug, given as an infusion, will cost $4,312 per infusion for a patient, or $56,000 a year.
Medicare has yet to make a coverage determination on the drug; but for most Part B Medicare coverage, Medicare pays 80 percent of treatment costs, while beneficiaries pay the remainder. According to an estimate from the Kaiser Family Foundation, Medicare beneficiaries could pay up to $11,500 in coinsurance for a year of Aduhelm, or aducanumab, treatment.
"This represents nearly 40 percent of the $29,650 in median annual income per Medicare beneficiary in 2019," according to KFF.
Most Medicare beneficiaries have supplemental health insurance that could cover a portion of their out-of-pocket costs for the drug. Still, "beneficiaries with Medigap or retiree health could see their premiums rise to account for higher plan liability associated with costs for Aduhelm," according to KFF.