There’s a major cost associated with landmark drug the FDA approved to help patients with Alzheimer’s disease.
The drug called Aduhelm will cost $56,000 a year.
Most of those battling Alzheimer’s disease are 65 and older, so Medicare comes into play for many people.
"With a $56,000 price tag, Medicare’s coinsurance for patients is 20% of that total. So we are talking out of pocket costs upwards of $11,000 annually," said Juliette Cubanski. She is a Medicare policy expert at the Kaiser Family Foundation.
Cubanski says Medicare patients have a 20% coinsurance rate on drugs after they meet their deductible.
"It is really not clear. For people outside of Medicare, they may be able to tap into patient assistance programs that have been set up by the manufacturer that have been set up to help with out of pocket costs," she said.
Those with Medicare can’t tap into that resource, but there may be criteria that Medicare establishes, which they often do with certain drugs, to help patients with coverage.
"If Medicare offers a national coverage determination for this new drug, that could spell out specifically who with Alzheimer’s disease would be able to get this drug covered for them and paid for them by Medicare," said Cubanski.
Usually after a drug is approved by the FDA, it takes a few weeks to be available to patients.
No word yet on and exact date of when it will be available.