Cumberland Falls, Cumberland Falls State Park, Honeybee/Corbin, Kentucky

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Thursday, July 15, 2021

Cleveland Clinic and Mt. Sinai Refuse to Prescribe Aduhelm (adalimumab) ...

Bravo, to both major healthcare clinics, for the pushback against a drug that has not proven its efficacy, and for which the FDA curiously bent the rules. 

I don't think people realize, yet, how significant this is and how much of an impact this will have on our current healthcare system and drug cost overall.

So what does this mean, and why is this so great? 

Well, IMO, the business strategy on this drug was to create consumer hype for the first Alzheimer's drug, resulting in a consumer push on physician-prescribing patterns, as well as insurance companies to cover it. 

Typically, all drugs being equal (proven efficacy and safety, cost), insurance companies controll the market share, rather than the consumer, based on rebates (kickbacks), isn't usually a good thing.

HOWEVER, in the case of Aduhelm -  which was FDA approved despite NOT having proven efficacy - many insurance companies are refusing coverage despite rebates - so it's actually a good thing.

Hey, they're actually doing their jobs, for once, and what they were originally designed to do, managing the cost of healthcare properly despite kickbacks.

HOWEVER, some insurance companies are covering it and taking the rebates.

So as backup, despite what insurance companies do, the physicians and administration at these two large, well-respected U.S. healthcare clinics, got together and decided not to prescribe it, essentially sending a strong message to both Biogen and insurance companies: "Nope.  We don't care if you decide to cover it or not (and get rebates), we're not prescribing a $56,000 drug, without proven efficacy, to any of our Alzheimer patients - and we have many - so good luck with that." :)

In other words, this was pharma - specifically Biogen, who already produces the most expensive drug in the world, Spinraza (which has apparently fallen short of its clinical-trial data in the real world) - pushing the limits of our current healthcare system and cost - and losing.  It sets a precedent, and that's a good thing ;)

For more, read two posts below with links :)

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