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The Food and Drug Administration’s decision to grant wide-ranging approval to the controversial, pricey new Alzheimer’s drug Aduhelm will have an eye-popping impact on Medicare finances. The question is exactly how big the impact will be.

Estimates of how many seniors on Medicare will actually take Aduhelm, which has a list price of $56,000, vary wildly. Some experts have guessed at relatively low patient interest, around 500,000 people. Biogen, the company behind the drug, has put its target population far higher, around 1 million to 2 million people.

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But technically, since the FDA approved the drug for every Alzheimer’s patient, not just those with early-onset disease, the number could skyrocket toward 5.8 million, the number of adults over 65 with Alzheimer’s.

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