Prognosis
Insurers Balk at Paying for Biogen’s $56,000-a-Year Alzheimer’s Treatment
- Many don’t see Aduhelm as ‘medically necessary’: survey
- High cost, conflicting data add up to limited patient access
Pedestrians walk past Biogen Inc. headquarters in Cambridge, Massachusetts.
Photographer: Adam Glanzman/BloombergThis article is for subscribers only.
U.S. health insurers say they want more proof before paying for Biogen Inc.’s Aduhelm, stalling sales of the costly new Alzheimer’s therapy that the company hailed as a breakthrough for patients.
None of the 25 large insurers that responded to a Bloomberg News survey judged the $56,000-a-year drug “medically necessary,” a term used to describe treatments that are needed for specific ailments and meet medical standards. Most have deemed Aduhelm experimental, while some say they’re still evaluating it.