The Food and Drug Administration (FDA) recently approved a new drug from Eli Lilly to treat Alzheimer’s disease.
Called Kisunla, this monthly IV infusion therapy is designed for people in the early stages of Alzheimer’s.
According to the Alzheimer’s Association, the treatment targets and destroys amyloid plaques in the brain, which are believed to slow the disease’s progression.
However, the cost of this treatment is steep—$32,000 per year. Another similar therapy, Leqembi, costs $26,500 annually, and Aduhelm, approved by the FDA in 2021, initially cost $56,000 per year before Biogen, its manufacturer, halved the price and then discontinued the drug.
With nearly 7 million Americans living with Alzheimer’s—a number expected to rise to 13 million by 2050—many could potentially benefit from these treatments. Yet, the high cost is a significant barrier.
Gary Young, director of Northeastern University’s Center for Health Policy and Healthcare Research, explains that several factors influence drug pricing, including research and development costs, market competition, and demand.
The average cost to bring a drug to market exceeds a billion dollars, partly due to the high failure rate during early trials.
These high costs could limit patient access and increase overall healthcare spending. In 2022, U.S. healthcare spending reached $4.5 trillion, accounting for 17.3% of the country’s gross domestic product.
Young warns that this trend could continue, leading to a potential crisis as more expensive treatments become available. While it’s important to have access to new drugs and technologies, there must be a balance with broader public health investments.
Access to these expensive drugs largely depends on insurance coverage. Medicare and Medicaid are set to cover Kisunla and Leqembi, but it’s up to individual insurance companies to decide if they will include these treatments.
Some insurers might be reluctant due to the high costs, which could limit funds available for other patients and treatments. Even with insurance coverage, patients may still face significant out-of-pocket expenses.
Clinicians also have to weigh the benefits of these drugs against their costs. Not every patient will experience the same benefits, and the high cost might not justify the modest progress in some cases.
The current treatments are based on the amyloid hypothesis, which suggests that Alzheimer’s is caused by amyloid plaques in the brain. However, the neuroscience community is divided on this theory, with some experts questioning whether the plaques are a cause or a symptom of the disease.
Aduhelm’s approval by the FDA, despite uncertainties about its benefits, led to a congressional inquiry and reluctance from major healthcare systems to offer the drug due to risks like brain swelling and bleeding.
This skepticism underscores the debate within the scientific community about the effectiveness of these treatments.
Despite the controversies, these drugs remain the only available options for treating Alzheimer’s, providing some hope for patients. Eli Lilly’s Kisunla has shown potential in slowing disease progression and improving cognitive function in some patients.
As more drugs enter the market, increased competition could lead to lower prices, assuming the new treatments offer similar benefits.
The future of Alzheimer’s treatment is still uncertain, with ongoing debates about the best approaches and the high costs of new therapies.
However, the approval of Kisunla represents a step forward, offering a new option for those in the early stages of this challenging disease.
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