The FDA on June 7 approved Biogen Inc.'s Aduhelm (aducanumab) to
treat Alzheimer's disease, the first novel therapy approved in this indication
since 2003. The accelerated approval of Aduhelm was controversial as results of
two Phase III trials in patients with early-stage and mild Alzheimer’s
contradicted each other. There are a host of other Alzheimer's medications on
the market, all of which are covered under the pharmacy benefit. The majority
of insured people under commerical and Medicaid formularies have plans that put
Alzheimer's drugs under the preferred/preferred (prior authorization and/or
step therapy) tier and covered/covered (PA/ST) tiers. More than half of payer
pharmacy benefit formularies do not require step therapy or prior authorization
for Alzheimer's medications.
NOTE: Under the pharmacy benefit, the total covered lives under
commercial, health exchange, Medicare and Medicaid formularies are 170.0
million, 11.7 million, 47.8 million and 69.8 million, respectively.
SOURCE: Managed Markets Insight & Technology, LLC database as of June 2021
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