welcome to the organic green doctor blog

i am a family physician who was diagnosed with
early mild cognitive impairment(mci) amnestic type on december 21, 2010
this is a precursor to alzheimers disease
because of this diagnosis i have opted to stop practicing medicine
this blog will be about my journey with this disease
please feel free to follow me along this path
i will continue blogging on organic gardening, green living,
solar power, rainwater collection, and healthy living
i will blog on these plus other things noted to be interesting

Friday, December 3, 2021

alzheimers news-why did medicare premiums go up


one reason 
aduhelm or aducanumab

what is aduhelm or aducanumab
if you have read this blog much you know what it is

aduhelm or aducanumab is a monoclonal antibody thats given as a monthly infusion 
it binds to amyloid plaques in the brain and removes them
in clinical trials which i was and am still in 
there was an improvement in the decline of memory
around 20%

it got approved by the fda for use in mild cognitive impairment or early alzheimers this year

most patients that qualify for treatment are older folks
most are on medicare

medicare hasnt decided to approve coverage for the aduhelm or aducanumab yet
that may come later next year

so right now they arent paying for aduhelm or aducanumab infusions
neither is any other insurance

if you get it right now then
you are paying for it
you are like me 
in a clinical trial receiving it
at not cost

so right now in 2021 and entering 2022 medicare is paying nada for this drug
even though they arent sure they will cover it
they still say they might
they decided whoever they are to figure the cost of aducanumab in next years medicare premiums since they could become the major payor for the drug 

even though now they whoever they are arent sure they will even approve its use until more studies like the one i am in is finished
that may take a couple of years or longer

the increase of $21.60 is the highest increase ever in medicare premiums
the average increase in social security checks of $92 a month will be eaten up partially by this medicare premium costs

the aduhelm or aducanumab costs is $56,000 a year for about 12 infusions
now i have had 32 infusions in the study i am in
that would be about $150,000 in infusions if i had to pay for them or medicare
now in the study i was in i got 25 infusions of placebo
i was hoping they were the real dug

medicare cant negotiate prices
i repeat they cant negotiate prices

do you ask yourself
why is that

i think we know 
lobbyists and campaign donations
that we have to sort of pay for

it seems fair that biogen gets paid for the millions and millions they spent on development of this drug
what good is it if no one can afford the price they are asking for

remember also there are several millions of folks who will qualify to receive this drug
if it gets approved for coverage by medicare
usually private insurances follow suit with what medicare does
should all medicare folks have to pay a aduhelm tax each month

i dont thinks so
i would think covid has cost medicare more than any drug ever would

when you start paying that higher premium next year
at least you will know what about $10 of it is for

so doing calculations since there are about 61,000,000 medicare folks
thats enough money to pay for about 1,300,000 folks to be treated each year at those prices

an aside
i get my first dose of the maximum dose of aduhelm or aducanumab at 10 mg per kg this week at ucla in the aduhelm study i am in
i had an mri last week
if its normal they will allow me to get the infusion on wednesday
if its not normal ie if it shows a microbleed or aria then the infusion will be delayed until it resolves

the 10 mg per kg dose is the dose that is associated with these arias or microbleeds
i will have another mri in a month to be sure that hasnt happened

these arias or microbleeds are usually asymptomatic and resolve
minor ones dont prevent you from receiving the infusions

so far i have had 13 infusions of the aduhelm in increasing doses with no evidence of symptoms or aria

heres hoping it stays this way

folks with apoe 4 homozygous like i have are at the greatest risk for aria

dr daniel gibbs a retired neurologist who was on the cbs news sunday show this last week was in the aduhelm study
he too has the apoe 4 homozygous gene
he developed rare severe aria and had to drop out of the study
this is well described in his well written book a tatto on my brain
he also describes what its like to have this disease

it is the side effect that folks need to consider if they are going to take this drug
its risk vs benefit

the way i look at is
if i do nothing the risk is 100% i will probably die from alzheimers
if i take aduhelm infusions there is a chance that looks like around 20% that memory decline will be slowed but i will probably still die of alzheimers disease just maybe a little later 

that 20% is worth the risk
most folks with this diagnosis would take that risk every time

the organicgreen doctor