A controversial new drug for Alzheimer’s

Guests: Jose Delgado, Washington correspondent of El Nuevo Dia, and Axios' Bob Herman and Erica Pandey.

Credits: Axios Today is produced in partnership with Pushkin Industries. The team includes Niala Boodhoo, Sara Kehaulani Goo, Dan Bobkoff, Alexandra Botti, Nuria Marquez Martinez, Sabeena Singhani, and Alex Sugiura. Music is composed by Evan Viola. You can reach us at [email protected].

Go deeper:

• FDA approves Biogen's Alzheimer's drug despite lack of evidence
• The future of concerts is hybrid

Transcript

NIALA BOODHOO: Good morning! Welcome to Axios Today!

It’s Tuesday, June 8th.

I’m Niala Boodhoo.

Here’s what we’re watching today: the Biden administration’s split stance on Puerto Ricans and benefits. Plus, the upside to online concerts.

But first, today’s One Big Thing: a controversial new drug for Alzheimer’s.

NIALA: The FDA has approved a new Alzheimer's drug for the first time in almost 20 years. It's to treat the more than 6 million Americans diagnosed with Alzheimer's disease, but the effectiveness of the drug,aducanumab, or aduhelm is up for question, Bob Herman covers healthcare business for Axios.

Hey, Bob.

BOB HERMAN: Hey Niala.

NIALA: So I think we have to start with, just to be clear, the FDA has approved this for Alzheimer's, but it's not clear how effective it is at treating Alzheimer's.

BOB: That's right. So the company that makes the drug Biogen ran clinical trials, one of the clinical trials failed and the other maybe kind of, sort of showed some clinical benefit.

the FDA issued an accelerated approval, which basically said, we're going to approve this, but Biogen, you have to conduct another study to make sure it actually works.

NIALA: what do we know about what the drug actually does?

BOB: in the trials, the drug failed. but Biogen went back and looked at the data and said, okay, we think it actually made some of these brain plaques, a decline, which they think might help, slow the progress of Alzheimer's.

They're running with this theory that if you lessen these brain plaques, it'll help people recover from Alzheimer's. Again, that's still not really proven. That's why Biogen needs to run another confirmatory trial to see if that's actually the case

NIALA: Bob, how expensive is this?

BOB: The drug has a list price of $56,000 a year. And that price is the uninsured . Price. But, since so many Alzheimer's patients are on Medicare, Medicare likely if it decides to do so, will pay, uh, probably a large portion of that.

NIALA: there's so many families who are living with Alzheimer's. Why has it been so hard to find treatments?

BOB: Alzheimer's research has been going on for decades. And there's been this slowly building scientific consensus that says maybe this hypothesis about these brain plaques is not really.

Something that we should be focusing so much on. this drug approval kind of bring some life back into the argument, but again, we don't actually know if this drug works.

NIALA: And what does it this mean for the FDA approval process going forward?

BOB: this is under a very, complex FDA approval process called accelerate approval. if the confirmatory trial doesn't prove that it works, the FDA can pull it off the market, but that could take a very long time.

Biogen can still make billions of dollars in the meantime. so this just might reignite controversy over whether the accelerated approval pathway is legitimate pathway.

NIALA: So you've mentioned a few times that it's controversial besides the drug company, are there advocates who were pushing for this drug to be approved?

BOB: Yes, many patient advocacy groups involved with Alzheimer's. We're really hoping that this would get approved and. And it did. but it's worth noting.

A lot of those groups, are affiliated with Biogen and it toes the line of desperately wanting a treatment for a debilitating disease. Something that's just terrible to watch, but also balancing that with the science and the science, from what everyone in the community has been saying, it's just not clear that this drug has proven to work.

NIALA: Axios' healthcare business reporter. Bob Herman is based in Northwest Indiana. Thank you, Bob.

BOB: Thanks. Niala.

NIALA: We’ll be back in 15 seconds with Biden and benefits for Puerto Ricans.

[ad break]

Welcome back to Axios Today! I’m Niala Boodhoo.

NIALA: Yesterday President Biden urged Congress to extend supplemental security income benefits to residents of Puerto Rico, but he did so in his statement that added his Department of Justice would also be filing a brief to the Supreme Court in support of denying benefits to a Puerto Rican man.

Jose Delgado is the Washington correspondent of El Nuevo Dia and is here to catch us up. Hi Jose, thank you for being with us.

JOSE DELGADO: Thank you for inviting me.

NIALA: Jose, I think I should start with the obvious question, which is if Puerto Ricans are U.S. citizens, why can't they get Social Security benefits?

JOSE: Well, you know, Puerto Rico is a territory of the United States so that means that the Congress has plenary powers over Puerto Rico and they decide which programs they can extend to Puerto Rico.

NIALA: Do Puerto Ricans pay taxes the same as on the mainland?

JOSE: No, that has been the argument of the federal government regarding the extension to Puerto Rico of these welfare programs or aid programs that Puerto Rico has. Normally in Puerto Rico, they will not pay income tax. They pay Social Security as everybody in the state, they also pay their dues regarding Medicare. But if you are not working for the federal government or making income in the state, you don't have to pay federal taxes.

NIALA: So President Biden is saying he doesn't support this law, that the department of justice is defending in this case. Does that make a difference if the Supreme court rules in favor of the United States, what the president's opinion is?

JOSE: Well, you know, my, my view is that it really doesn't make sense. They are saying for, for one side, let Congress decide that I really see as, as a policy in favor of the authority of Congress over Puerto Rico and the territories, but at the same time that tells the Congress, please amend this law and include Puerto Rico, provide parity in the SSI program. The basic problem of the relationship between Puerto Rico and the United States is the authority of the Congress to regulate Puerto Rico, to control Puerto Rico. So they will decide case by case, program by program which program will apply to Puerto Rico.

NIALA: Jose Delgado is the Washington correspondent of El Nuevo Dia. Thank you, Jose.

JOSE: Thank you.

C BLOCK [slug] [time]

NIALA: schools and workplaces. Aren't the only spaces that could stay hybrid long after the pandemic ends. A lot of concerts are also keeping hybrid options. Axios’ Erica Pandey is here to explain more. Hey Erica.

ERICA PANDEY: Hi, Niala.

NIALA: So many people are excited about going back to concerts and other big entertainment events this summer. Why are we still seeing a hybrid option?

ERICA: So, you know, it's often cheaper. You can go to the concert virtually without waiting in those lines or getting jostled by strangers. And obviously people want to go see some in-person shows as well, but for those who want to stay home, or if you're not that invested in an artist but you just want to check it out, hybrid could be a great option.

NIALA: What's the business of these remote productions?

ERICA: It is huge, huge. So Dua Lipa put on a virtual concert in November of 2020, which was obviously in the thick of the pandemic that cost $1.5 million and took five months to put together. In the end 5 million people tuned in, which is way more than any live in-person show in history.

So for artists, it can be a really great way to reach more people with just that one show. And what I found really interesting was that tickets for her in-person tour spiked 70% after that live stream concert. So it can be this great way to build hype, too, even if you're going to do the in-person fun thing after it.

NIALA: So it sounds like the hybrid option for concerts is here to stay.

ERICA: The new cheap seats for the show are in your living room.

NIALA: Axios’ Erica Pand3y. Thank you, Erica.

ERICA: Thanks, Niala.

NIALA: Before we go: today is World Ocean’s Day. And while there’s only truly one global ocean, it’s typically split into four regions: the Arctic, Atlantic, Indian, and Pacific ocean basins. But did you know that most countries now recognize a fifth ocean basin, known as the Southern Ocean? That’s made up of the waters around Antarctica, and National Geographic is today updating its map policy to show this as a distinct ocean region. Nat Geo says doing so will make it easier to protect these waters.

And that’s all for today! You can reach our team at podcasts at axios dot com or reach out to me on twitter.

I’m Niala Boodhoo - thanks for listening - stay safe and we’ll see you back here tomorrow morning.