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Elder Law • Medicaid Planning • VA Benefits

Medicare to Limit Coverage of Alzheimer’s Drug

Mar 10, 2022

The Washington Post reports that the Centers for Medicare and Medicaid Services “proposed covering a pricey, controversial Alzheimer’s drug but, in a highly unusual step, restricted it to people enrolled in approved clinical trials, sharply limiting the number of eligible patients.” The draft decision “means the program would cover Aduhelm [aducanumab] and similar drugs in development…only in studies approved by CMS or supported by the National Institutes of Health.”

The New York Times reports the agency’s final decision is “expected by April 11 after a public comment period that runs from now until mid-February.” HHS Secretary Xavier Becerra on Monday “said that he was instructing CMS to re-examine the premium hike ‘given the dramatic price change of the Alzheimer’s drug, Aduhelm.’”

The Wall Street Journal reports that Medicare officials said they would cover Biogen’s drug Aduhelm for Alzheimer’s disease, but on the condition that patients are in clinical trials and have early-stage symptoms.

The AP reports, “Medicare said Tuesday it will limit coverage of a $28,000-a-year Alzheimer’s drug whose benefits have been widely questioned, a major development in the nation’s tug-of-war over the fair value of new medicines that offer tantalizing possibilities but come with prohibitive prices.”

From the news release of the American Association for Justice.

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