Now that the U.S. Food and Drug Administration has granted accelerated approval to the widely anticipated Alzheimer’s drug from Eisai and Biogen, a key question is the extent to which payers — private and public — will cover the treatment.
Such decisions are based on myriad factors, starting with the $26,500 price tag. But there are other considerations, including the quality of the clinical trial data, side effect concerns, the patient population for which the medicine is approved, and budgetary constraints.
Of course, there are expectations that a large swath of patients may qualify for treatment — the FDA decision indicates the drug can be used in those with mild cognitive impairment or mild dementia stage of disease. This can add up quickly. Approximately 12% to 18% of people age 60 or older are living with mild cognitive impairment, and 10% to 15% develop dementia each year, according to the Alzheimer’s Association.
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