Pfizer Heart Failure Medication Lawsuit Ruling Could Broadly Impact Medicare, Lead to Expensive Aduhelm Coverage

Pfizer is seeking legal backing for its plan to pay healthcare costs for Medicare patients taking one of its pricy ($225,000 annually) heart failure medications. The outcome of this federal lawsuit has far-reaching consequences and could pave the way for Biogen’s Aduhelm to enter the Medicare sphere. Opponents consider copay programs such as Pfizer’s to be equivalent to bribes.

“A ruling in Pfizer’s favor would legalize something that is viewed as a kickback under current law, and would jeopardize taxpayer coffers by spurring a “gold rush” of pharmaceutical companies to cover Medicare copays for expensive drugs. That could include Aduhelm, Biogen’s pricey Alzheimer’s treatment.” Read more here.

(Source: Bob Herman, Axios, 7/8/21)