FDA APPROVAL CONTROVERSY
The accelerated approval of Aduhelm has been controversial for several reasons, and the issue is ongoing. For more information, see this article.
Aduhelm (aducanumab-avwa) is a brand-name prescription medication. The Food and Drug Administration (FDA) has approved it to treat certain people with Alzheimer’s disease.
For more information about Aduhelm’s uses, refer to this article.
Here are some details about Aduhelm, which is a biologic:
- How it’s given: intravenous infusion
- Biosimilar version: not available
Read on to learn about Aduhelm and cost, as well as how to save money on prescriptions.
As with all medications, the cost of Aduhelm can vary. Factors that may affect the price you’ll pay include:
- your treatment plan and dose
- your insurance coverage
- the cost of the visit to your healthcare professional to receive doses of Aduhelm
- whether Aduhelm has a savings program (see the “Financial and insurance assistance” section below)
To find out the cost of Aduhelm for you, talk with your doctor or insurance provider.
Below is information you may want to consider if you have insurance and receive Aduhelm.
Prior authorization. If you have insurance, your insurance company may require prior authorization before it covers Aduhelm. This means the company and your doctor will discuss Aduhelm in regard to your treatment. The insurance company will then determine whether the medication is covered. If a drug requires prior authorization, but you start treatment without prior approval, you could pay the full cost of the medication. You can ask your insurance company whether Aduhelm requires prior authorization.
Type of insurance coverage. Aduhelm is given by your doctor or another healthcare professional. If you have insurance, the price of your Aduhelm doses may be billed through your primary health insurance instead of the prescription drug portion of your insurance. This depends on your insurance coverage and where you receive your Aduhelm doses, such as at your doctor’s office, an infusion clinic, or a hospital. If you have questions about this process, contact your doctor or insurance provider.
If you need financial support to pay for Aduhelm, or if you need help understanding your insurance coverage, help is available. For example:
- A program called Biogen Support Services is available from the manufacturer of Aduhelm, Biogen. This program may be able to assist with the costs of Aduhelm. For more information and to find out if you’re eligible for support, call 833-425-9360.
- Some websites provide details about drug assistance programs, ways to make the most of your insurance coverage, and links to savings cards and other services. Two such websites are:
To learn more about saving money on prescriptions with or without insurance, check out this article.
Here are answers to some frequently asked questions about drug cost and Aduhelm.
How can I figure out Aduhelm’s cost per dose?
The best way to figure out how much Aduhelm may cost per dose is by contacting your doctor’s office or insurance provider. Many different factors can affect the cost of your medication, including your dose, your costs for the appointment to get your dose, and your insurance plan.
If you have questions about Aduhelm’s cost per dose, talk with your doctor or insurance provider.
Will my dose of Aduhelm affect my cost?
Yes, your dose of Aduhelm may affect the cost of the drug. This is because if you take a higher dose of medication and there’s more drug in your dose, it will likely cost more. However, it’s possible that if your insurance covers Aduhelm, your copay may still be similar.
If your dose of Aduhelm is changing, talk with your doctor or insurance provider to see if the cost may also change.
Aduhelm contains the active aducanumab-avwa and it’s available only as a brand-name biologic drug. It doesn’t come in a biosimilar version. A biosimilar medication is a drug that’s similar to a brand-name biologic drug (the parent drug). Also, biosimilars tend to cost less than brand-name medications.
WHY ARE COSTS DIFFERENT FOR BIOLOGIC DRUGS VS. BIOSIMILAR DRUGS?
Biologic drugs can be expensive because of the research needed to test their safety and effectiveness. The manufacturer of a biologic drug can sell it for up to
12 years. When the biologic drug’s patent expires, multiple manufacturers can create biosimilar versions. This marketplace competition may lead to lower costs for biosimilars. Also, because biosimilars are very similar to biologic drugs, they don’t require the same costly testing.
Now that you’ve learned about cost and Aduhelm, you may still have some questions. Talk with your doctor or pharmacist, who can provide personalized guidance about cost issues related to Aduhelm. But if you have health insurance, you’ll need to talk with your insurance provider to learn the actual cost you would pay for Aduhelm.
Here are some other resources you may find helpful:
- Medicare drug coverage. To learn about Medicare coverage and costs for drugs such as Aduhelm, see these articles about Medicare Prescription Drug Plans, drug coupons and Medicare, and the Medicare drug list.
- More details. For details about other aspects of Aduhelm, refer to this article.
- Information about Alzheimer’s disease. For more information about Alzheimer’s disease, see our dementia hub.
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.