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Go read up on the history of ACTH (Acthar Gel) if you want to see how far this sort of stuff goes. Short summary is its a medication that cost approx $20 a vial for 50+ years and then got hiked to $40,000 a vial in the United States. It was the best known (gold standard) treatment for things like infantile spasms in newborns.

If it worked, $56K per year for a brand new drug for Alzheimer's isn't really that bad.

The problem is that is doesn't work. However, people will feel compelled to get it for their suffering relative as it is the only "approved" treatment.

Likely years ago somebody at Biogen used a spreadsheet to calculate NPV under a range of scenarios, and from that decided to license this drug from Neurimmune. So it’s this or nothing, unfortunately.

It's a monoclonal antibody. Biologics are expensive to produce.