Medicare Proposes to Restrict Coverage of Controversial and Costly Alzheimer’s Drug – By Yuval Rosenberg (The Fiscal Times) / January 12, 2022
Medicare officials on Tuesday proposed limiting coverage of a controversial and expensive new Alzheimer’s drug to patients in approved clinical trials. The proposal could sharply limit the number of patients who use Biogen’s Aduhelm, a monoclonal antibody treatment for Alzheimer’s, which has faced questions about both its cost and its effectiveness. The decision also applies to similar drugs in development.
The preliminary proposal by the Centers for Medicare and Medicaid Services (CMS) is highly unusual. “CMS almost never demands such trials for a drug already approved by the Food and Drug Administration,” The Washington Post’s Laurie McGinley and Amy Goldstein note.
Dr. Lee Fleisher, the chief medical officer and director of the Center for Clinical Standards and Quality at CMS, said in a statement that the proposal “is the result of robust evidence analysis conducted through a thorough review process that found while there may be the potential for promise with this treatment, there is also the potential for harm to patients.”
