Biogen teaming with Cigna, CVS Health to increase access to its Alzheimer's drug
The company will enter into a value-based contract with Cigna and an initiative with CVS Health based on screening and education.
Photo: Jeff Lagasse/Healthcare Finance News
When the U.S. Food and Drug Administration approved aducanumab, an Alzheimer's medication from drugmaker Biogen, there was controversy as to whether the drug was actually effective. But that hasn't stopped Biogen from teaming up with major payers, including Cigna and CVS Health, to increase patient access to the drug.
Partnering with Japanese pharmaceutical and research company Eisai, Biogen said this week that it intends to enter into a value-based contract with Cigna to streamline access to the Alzheimer's drug, marketed as Aduhelm, and will be tracking performance based on certain outcome metrics.
Alzheimer's disease imposes a tremendous burden on patients, caregivers and society as a whole," said Dr. Steve Miller, executive vice president and chief clinical officer at Cigna. "Given the known infrastructure challenges in the U.S., we are working to ensure that the patients who will benefit most from this new treatment have a clear path to access it."
Biogen has also entered into an initiative with CVS Health focused on brain health, screening and disease education. As part of that effort, cognitive screenings will be available through CVS Health's Project Health, a health services program addressing care disparities for uninsured and underinsured Americans, particularly in racially and ethnically diverse communities.
Patients or their caregivers will be able to consult with onsite healthcare providers about their personalized screening results.
"We all recognize that the optimal delivery of healthcare requires multiple stakeholders working together," said Dr. Sree Chaguturu, chief medical officer of CVS Caremark. "We are committed to addressing systemic health disparities in our country, and this novel initiative is an example of how we can use our enterprise assets and capabilities to make a real difference."
The program is scheduled to begin in September in Atlanta, Boston/Providence, Charlotte, Charleston/Columbia, Chicago, Dallas/Fort Worth, Detroit, Houston, Jackson/Memphis, Los Angeles, Miami, New York, Philadelphia and Washington.
WHAT'S THE IMPACT?
According to NPR, aducanumab has been controversial in that it's unclear whether it truly slows the progression of Alzheimer's disease. It has shown effectiveness at reducing plaques that build up in the brains of people afflicted with the disease, but separate studies have disagreed on whether it slows the decline in memory and thinking typically associated with Alzheimer's.
Among the FDA's conditions of approval is that Biogen will be required to conduct another clinical trial to confirm that the reduction of plaques translates into true clinical improvement. If that study fails to demonstrate the drug's efficacy, the FDA could withdraw the approval, effectively pulling the product from shelves.
FDA approval could actually make it difficult for Biogen to find enough patients to take part in the clinical trial, since patients will have access to the drug without participating in the study and may not want to risk being given a placebo.
THE LARGER TREND
With an aging baby boomer population and ever larger numbers of people being diagnosed with Alzheimer's, the cost of treating the disease has reached significant levels, and according to a 2018 report from the Alzheimer's Association, the cost will only grow. It's projected to reach as high as $1.1 trillion by 2050.
By that time, the number of Americans officially diagnosed with Alzheimer's could reach nearly 14 million, at least if current rates hold.
Yet despite the sobering projections, there's a silver lining from a cost perspective. Early detection is the key. Diagnosis during the mild cognitive impairment, or MCI, stage of the disease could save up to $7.9 trillion and also make the condition's effects more manageable as the person ages.
Medicare and Medicaid feel the cost impact as well. While Medicare typically pays about $7,000 per year for an Alzheimer's-free individual, a person with the disease costs about $23,000. Those figures become compounded when factoring in Alzheimer's rising prevalence, with one in 10 people age 65 and older showing symptoms of the disease, and Alzheimer's deaths rising 123% between 2000 and 2015.
Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com
