Hospitals and insurance companies won't offer new Alzheimer's drug

Controversy over new Alzheimer's drug

The first Alzheimer's drug to the market in 20 years is being dogged by controversy, as the Cleveland Clinic and New York's Mount Sinai hospital, along with a handful of insurance companies say they will not cover it.

If you are looking for the new Alzheimer's Drug Aduhelm, also known as Aducanumab, you may have a hard time finding it.

Despite FDA emergency use approval, some hospitals and insurance companies are refusing to offer it.

On Thursday, two major hospital systems, Mount Sinai Health System and the Cleveland Clinc, both said they would not offer the nearly $60,000 a year intravenous treatment made by the drug company Biogen.

The hospitals are waiting to see what Medicare decides.

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The turning point appeared to be the FDA calling for an independent federal probe into how its own doctors interacted with Biogen prior to authorization.

"If the hospital pays the $60K they have to get the money back from the insurance company. So the insurance says at that point they're not paying for it, then they have to suddenly bear the cost of the drug for all of these patients." said Dr. Devi Nampiaparampil of NYU Langone Health.

FOX 5 NY reached out to both the Clevland Clinic and Mount Sinai.

In a statement, the Cleveland Clinic said: "Based on the current data regarding its safety and efficacy, we have decided not to carry Aducanumab at this time. However, we support continued research in this area, and when additional data becomes available, we will re-evaluate this medication for use in our patients."

Mount Sinai said: The FDA's approval of Aduhelm has raised serious concerns and questions by clinicians, patients, and caregivers, and a cautious approach is required. Mount Sinai Health System will not administer Aduhelm until the outcome of the FDA Inspector General's investigation of Biogen is complete."

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These statements are not sitting well with Aduhelm's manufacturer, Biogen.

"Biogen continues to stand 100% behind Aduhelm and the clinical data that supported approval," Biogen said in a statement. "If any patient is denied access to care. We encourage them to contact us for help."

If Biogen is allowed to continue to offer Aduhelm, it could be incredibly profitable for the company. It is estimated to make Biogen $65M this year, $1.1B next year, and $5B by 2025.