Major Insurers Weigh in on “Medical Necessity” of Biogen’s Aduhelm

As reported during Biogen’s third-quarter report in October, its controversial Alzheimer’s drug Aduhelm (aducanumab) is struggling to get traction in the marketplace. Some of it is physicians’ reluctance to prescribe it because of questionable efficacy and potentially serious side effects. One patient may have died as a result of those side effects, although that is still being investigated. In addition, insurers are reluctant to pay for the drug, which has a price tag of $56,000 per patient per year. Medicare is still evaluating the drug to make its reimbursement recommendation, but a final decision isn’t expected until March or April 2022.