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Biogen’s Greed Will Devastate Seniors, Shows Vital Need for Prescription Drug Reform

By June 24, 2021No Comments

Protect Our Care Releases New Fact Sheet As Part of Lower Rx Summer

Protect Our Care is releasing a fact sheet outlining the costs and implications of Biogen’s new Alzheimer’s medication, Aducanumab, as part of Week 3 of Lower Rx Summer, which is focusing on how drug prices hurt seniors. These costs demonstrate the urgent need to empower Medicare to negotiate to bring down the cost of prescription drugs.

Americans already pay three times more for prescription drugs than our counterparts around the world. With the recent approval of Aducanumab, an exorbitantly expensive and unproven Alzheimer’s drug, intensified costs are expected to become a fixture of American health care spending for years to come. The drug’s $56,000 price tag and estimated $11,200 out-of-pocket cost will push Aducanumab out of reach for the vast majority of patients, as the total cost is nearly double the income of 50 percent of Medicare beneficiaries. While the costs of Aducanumab are extreme, they don’t stop with the medication. PET scans and MRIs, which are not covered by Medicare for Aducanumab treatment, play a crucial role in the drug’s use, creating additional out-of-pocket expenses. The treatment of millions of patients will increase premiums and cost-sharing requirements across the board, particularly for seniors on Medicare. No one should be forced to decide between treatment for a devastating disease and financial ruin. 

Biogen’s greed is appalling —profits over patients, families, and the nation’s health care system. The public understands that drug manufacturers like Biogen are exploiting a broken system that allows skyrocketing drug costs at the expense of all else. That is why the majority of Americans support giving Medicare the power to negotiate for lower drug prices. Requiring Big Pharma to play fair will save nearly $600 billion on prescription drug costs, which can be reinvested to strengthen health care for millions of Americans, including those with Alzheimer’s. These savings could establish an out-of-pocket cap for drug costs under Medicare and expand Medicare benefits to include hearing, vision, and dental.

KEY POINTS

  • Biogen’s blatant greed is financially devastating to Alzheimer’s patients. Aducanumab, can provide no benefit to those suffering from Alzheimer’s if they cannot afford to access it. The drug’s $56,000 annual price creates out-of-pocket expenses so prohibitive, many will be unable to access the care they have been desperately waiting for. While Biogen enjoys soaring share prices, patients and their families will be forced to make the impossible choice between treatment and financial ruin.
  • Medicare cannot withstand the cost of Aducanumab. The drug will have groundbreaking implications for patients, taxpayers, and the entirety of the American health care system. Even if just two of America’s six million Alzheimer’s patients began Aducanumab, it would cause Medicare spending alone to explode by $90 billion – all for a single, unproven drug. A spending increase on this scale would raise premiums across the country, with Medicare beneficiaries experiencing the greatest hardship.
  • Seniors back bold action to reign in corporate profiteering and lower prescription drug prices. Americans know drug manufacturers are taking advantage of a broken system, with 80 percent identifying the pharmaceutical industry’s prioritization of profits as the reason for skyrocketing drug costs. The majority of seniors agree and 82 percent want the federal government to negotiate with Big Pharma to lower their prescription drug prices.

Biogen’s Blatant Greed Is Financially Devastating To Alzheimer’s Patients

Aducanumab’s Out-Of-Pocket Price Highlights Access Disparities For Seniors. The vast majority of Alzheimer’s patients are over 65, many relying on Medicare for health coverage. As an infusion drug, Aducanumab would be covered under Medicare Part B, which requires patients to pay 20 percent of the $56,000 per year price tag. $11,200 in annual out-of-pocket expenses for a single drug would easily push treatment out of reach for many, stressing the extreme disparities that exist for seniors attempting to access specialty drugs, particularly those who are low-income, people of color, and in poor health.

Biogen’s Price Gouging Preys On Vulnerable Patients. While Biogen offers inconclusive evidence of Aducanumab’s effectiveness, executives continue to insist the drug’s $56,000 price tag is ‘responsible’. For the millions of Alzheimer’s patients and their families, desperate for treatment options, Aducanumab’s cost is not responsible – it’s reprehensible. Half of Medicare recipients live on less than $29,650 per year. Even the Alzheimer’s Association called the price of the drug “simply unacceptable” and stressed the need for Biogen to reduce Aducanumab’s cost.

Biogen Stands To Make Billions As Seniors Struggle. Aducanumab is priced at a rate more than six times its estimated value. The Institute for Clinical and Economic Review has assessed that Aducanumab could only be cost-effective at a price under $8,300 per year. 

Aducanumab’s Price Puts Big Pharma’s Greed On Full Display. Even Wall Street analysts did not predict a pharmaceutical corporation would set such an outrageous price for an Alzheimer’s drug. On the day the F.D.A. announced Aducanumab’s approval, Biogen’s shares skyrocketed by 38 percent.

Medicare Cannot Withstand The Cost Of Aducanumab

Health Care Spending Would Surge. If only a third of Americans with Alzheimer’s receive Aducanumab, health care spending could increase annually by $112 billion. With the annual price set at $56,000, Medicare would be spending $90 billion on Aducanumab for two million patients and out-of-pocket spending for patients would be $22 billion for the drug alone. For context, Medicare Part D spent $90 billion in 2020, covering all of the prescription drugs of 46 million Americans. 

Cost-Sharing Requirements Would Skyrocket. Aducanumab’s astronomical price would expose the full brunt of Medicare’s cost-sharing requirements for the six million Medicare beneficiaries with no supplemental coverage. This cost sharing responsibility for Part B medications, like Aducanumab, will be particularly painful for the 90 percent of Medicare Advantage beneficiaries with plans requiring 20 percent coinsurance rates for in-network providers, with that figure surging to 50 percent for medications provided out-of-network. 

Aducanumab Will Increase Premiums For Seniors. Premiums for 56 million Medicare Part B beneficiaries will be heavily impacted by Aducanumab spending. Part B premiums are set equal to 25 percent of annual projected Part B expenditures. An escalation on the scale Aducanumab threatens would drastically alter yearly Part B spending, increasing the cost for all recipients.

Costs Extend Far Beyond The Drug Itself. While the costs of Aducanumab are extreme, the implications for Medicare don’t stop with the medication. PET scans and MRIs play a crucial role in the use of Aducanumab to both diagnose and monitor patients for potential serious side effects, such as brain swelling and bleeding. Medicare does not typically cover the costs of scans used to identify Alzheimer’s associated amyloid buildups and is being aggressively lobbied by scan manufacturers to cover imaging and at higher rates. The options are grim. Either press over-stretched patients to spend additional out-of-pocket dollars, or put pressure on an already overwhelmed Medicare budget to cover yet another Aducanumab related cost.

Aducanumab Is High Risk, High Uncertainty. Despite its high cost, there is no conclusive evidence that Aducanumab is an effective Alzheimer’s treatment, justifying the concern and confusion of FDA advisory committee members, doctors, and bio-pharma industry insiders. Not only has Biogen been unable to produce strong evidence of clinical benefit, despite its astronomical cost, Aducanumab has serious potential side effects. In two seperate clinic trials, 40 percent of patients experienced brain swelling and 17 percent experienced microhemorrhages. Only a broken system would allow the makers of an unproven drug to reap enormous profits from patients grappling with a devastating disease.

Seniors Back Bold Action To Lower Prescription Drug Prices

Seniors Support Federal Government Action To Lower Drug Costs. Nearly 70 percent of seniors want Congress to take action on drug prices by establishing an out-of-pocket limit for Medicare beneficiaries. 82 percent favor empowering the federal government to negotiate lower prescription drug prices, to protect against unconscionable launch prices like Aducanumab’s.

Americans Know Big Pharma Is Taking Advantage Of A Broken System. 75 percent of Americans don’t trust drug manufacturers to set reasonable prices for their drugs and eight in ten believe Big Pharma’s prioritization of profits is to blame for rising cost of prescription drugs.

Older Americans Want A Level Playing Field. Seniors have had enough of paying more for medications than their counterparts around the world. Legislative efforts by Democratic leaders would establish a ceiling price for all negotiated drugs by tying it to the average price in other countries and penalizing pharmaceutical corporations that don’t play by the rules. Six in ten Americans over 65 support tying what Medicare pays for prescription drugs to the amounts paid by other countries.