Estimated Wasteful Spending on Aducanumab Dispensing in the U.S. Medicare Population

Aducanumab, a weight-dosed Alzheimer's drug with uncertain benefits and high cost, could strain Medicare's budget if approved for widespread use. In April 2022, Medicare issued a final determination restricting aducanumab's use to clinical trials. However, Medicare's coverage decision may still be overturned by legal challenges, potentially leading to much higher uptake. Moreover, several other Alzheimer's infusion drugs similar to aducanumab are currently in the development pipeline.

Because aducanumab is available in two fixed-dose vial sizes, its use may result in large amounts of discarded drug and wasteful spending. To quantify the amount of discarded drug and potential savings that could be generated from more efficient aducanumab vial sizes, we analyzed patient weight distributions from a nationally representative sample of Medicare beneficiaries with mild cognitive impairment (MCI) or mild dementia.