New Alzheimer's Drug Could Cost the Government as Much as It Spends on NASA
3 min read
The Alzheimer's treatment will cost $56,000 per patient, and millions may use it. The result: "crazy numbers" for Medicare.
Private insurers may erect roadblocks to treatment, requiring patients to get additional tests or prove that other options haven't worked. But in normal circumstances, Medicare covers drugs that are approved by the F.D.A. Medicare decides what drugs to cover based on whether they are "reasonable and necessary," not on how much they cost.

Medicare is initially required to pay for this type of drug at its list price in addition to a 3 percent fee to the doctor who gives it. And then, after about a year on the market, it pays the average sales price plus 6 percent. For drugs with competition, that average price can be substantially lower than the sticker price. But for a drug like Aduhelm, which is the first of its kind, the…
Josh Katz, Sarah Kliff, Margot Sanger-Katz
Read full article