How did doctors, health systems and insurers respond to Aduhelm?
The Cleveland Clinic, the VA and most major private insurers declined to offer or cover it. Infusion infrastructure costs added to the burden, and six months after launch most payers had still not committed to coverage — a primary reason for the drug's commercial failure.
Many turned away from it. Several major health systems, including the Cleveland Clinic and the Department of Veterans Affairs, declined to offer Aduhelm to patients after approval. Most major private insurers waited for Medicare's coverage decision before deciding whether to cover it, and six months after launch most payers had decided not to cover it, at least for the time being. Medicare then restricted coverage to patients in approved trials. Because the drug required monthly infusions and repeated MRI monitoring for brain swelling, the infrastructure costs for clinics were also significant. The patient group UsAgainstAlzheimer's argued after the price cut that cost should now be off the table in Medicare's decision. The Alzheimer's Association later said Aduhelm's approval "provided hope for the millions of people living with early Alzheimer's" and began a new era of treatments. The limited uptake is a key reason Biogen ultimately discontinued the drug.