To the Editor We concur entirely with the Viewpoint by Gurwitz and Maurer1 on the high price of tafamidis for the treatment of transthyretin amyloidosis cardiomyopathy (ATTR-CM). The authors briefly addressed the potential problem of access and affordability for patients but do not provide details on cost. As this is a disease of the elderly, most patients in the US receiving tafamidis are Medicare beneficiaries. Medicare has a multilayered structure for drug coverage, and patients may be subject to high copayments, which vary depending on several factors, including supplemental insurance. For those with a high copayment, pharmaceutical company–sponsored, income-based financial assistance may be available, and charitable foundations inconsistently have available funds, but both are on a year-to-year basis.
Cuddy SAM, Coyle ML, Falk RH. Initial Monthly Cost of Tafamidis—the Real Price for Patients. JAMA Cardiol. Published online April 22, 2020. doi:10.1001/jamacardio.2020.0863
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