Fixed vial sizes for controversial Alzheimer’s drug could waste $605 million in Medicare spending each year

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Medicare could cost up to $ 605 million annually on the treatment of complex Alzheimer’s disease aducanumab if it is approved for effective use because it is given in vials containing specific doses that may not be suitable for all patients – which results in the waste of large amounts of unused funds. drug, a new UCLA study has found.

The treatment was found to be minimal if any benefit to Alzheimer’s patients. Although Medicare prescribes the drug for use in clinical trials, this decision may be overturned by appeal or legal challenge. Previous UCLA research has find that only treatment-related care services can account for approximately 20% of Medicare costs for patients treated.

Researchers suggest that aducanumab, currently priced at over $ 28,200 per patient per year, can be given in improved vial form to cover the cost, if approved for general use.

“With so many other Alzheimer’s drugs in the pipeline, aducanumab will not be the ultimate infusion treatment to threaten the Medicare budget,” said Dr. Carlos Irwin Oronce, assistant professor of medicine at UCLA’s Department of Internal Medicine and Research of Health Services. “Given the cost of Medicare in 2022 in part because of aducanumab, a greater focus on improved packaging could improve future Medicare spending, slow inflation, and reduce out-of-pocket beneficiaries.”

The paper will be published on June 27 in the review of their peers The American Geriatrics Society.

The drugs come in specific vial sizes — 170 mg / 1.7 ml and 300 mg / 3.0 ml — administered based on patient weight and other factors such as amyloid plaque value. The researchers used data from the 2016 Health and Retirement Survey for 65-year-old participants who had Medicare Part B insurance and had a Mental Illness (MCI) or disability.

For this study, the researchers took a dose of 10 mg / kg per month of the drug. According to the research team weight distribution, defined a patient’s weight range of 27 from 47 kg or less (104 lbs) to more than 150 kg (330 lbs). These formulations indicate the potential for a combination of vial aducanumab 27 required to make the drug effective for patients who are eligible. The authors then subtracted the total amount of drug in vials from the total number of doses required for each patient in the study in relation to the patient’s weight. For example, a patient weighing 85 kg requires 850 mg of the drug administered by 300 mg / 3.0 ml vials (total 900 mg), with 50 mg of the drug injected per month. Based on the efficacy of medications administered from each patient in a national representative research sample, the authors calculated the potential amount of medications lost to the entire U.S. Medicare population. patients which can be expected to receive aducanumab every year.

If approved for widespread use and 10% coverage of the drug, approximately 132,000 to 694,000 vials of expensive medication would be discarded, amounting to $ 115 million to $ 605 million for Medicare and enrollees each year. Reducing the vial size can reduce downtime by 60%.

The study has some limitations, the authors note. For example, the measures used for distribution misunderstanding may have been mistaken for distribution in some cases; The amount of plaque was taken from the population study not the PET survey of the study participants; and the authors assumed that the price tag remedy it will not change.

Additional authors of the study are Drs. John Mafi, Dr. Catherine Sarkisian, Julia Cave Arbanas, and Mei Leng of UCLA; Dr. Bruce Landon of Harvard University; and Cheryl Damberg of RAND. Oronce and Sarkisian have appointments with the VA Greater Los Angeles Healthcare System and Best has an agreement with RAND.

Most Alzheimer’s patients will not be eligible for clinical trials of a new complex treatment

Learn more:
Efficacy rates on aducanumab distribution in the U.S. Medicare population: A cross-sectional study, The American Geriatrics Society (2022). DOI: 10.1111 / jgs.17891

hintThe fixed size vial for the treatment of complex Alzheimer’s disease could cost $ 605 million in Medicare spending annually (2022, June 27) recovered 27 June 2022 from sizes-controversial-alzheimer-medicine.html

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