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The financial implications of widening semaglutide approval for new indications would depend on various factors, including reimbursement policies, patient outcomes, and overall health system performance. As discussed by Cubanski 2021 concerning new meds for Alzheimer’s, for comparison, although it is hard to know exactly how many Medicare beneficiaries will take Aduhelm for Alzheimer's, even a conservative estimate would lead to a substantial increase in Medicare spending. In 2017, nearly 2 million Medicare beneficiaries used one or more of the currently-available (and in my opinion not all that effective) Alzheimer’s treatments covered under Part D, based on Medicare Part D claims data. If just one-quarter of these beneficiaries would be then prescribed Aduhelm, approx. 500,000 beneficiaries, and Medicare pays 103% of $56,000 for Audhelm per year in the near term, then the total spending for Aduhelm in just one year alone would be nearly $29 billion. This expense, paid by Medicare and the patients who use this drug, would be an amount that would far exceed spending on any other drug covered under Medicare Part B or Part D, based on 2019 spending. To put this $29 billion amount in context, total Medicare spending for all Part B drugs was $37 billion in 2019. This does not include of course, treatment of known and potential adverse events of using Aduhelm, including serious severe and fatal side effects like intercranial bleeding

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