Another big kind of wrench in all of this was when the Centers for Medicare and Medicaid Services refused to cover Aduhelm under Medicare unless you were in a clinical trial. That, to me, seemed like the government saying, “This drug isn’t worth it.”
It was confusing and, in some cases, devastating. I talked to a couple people who were in the clinical trials who insisted that they felt like they had experienced a benefit being on the drug. I know there was disappointment with the price that Biogen chose to charge. I don’t think anybody in the patient or physician community defended that. But also, yeah, it’s important to remember there is just such desperation for anything that might work here. And there’s no waiting.
Patients who got lecanemab did 27 percent better on cognitive tests than those who got the placebo. But there are some important caveats. This trial focused on early-stage disease and all the patients had some degree of decline on what’s called the clinical dementia rating: an 18-point scale that determines cognitive function. Zero means you have no signs of cognitive decline; 18 is severe dementia.
We really focused this conversation on these two drugs, but I wonder what else is out there. Is there anything else waiting in the wings that feels promising?
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