Medicare Final CAR-T Policy Eases Coverage Requirements
Product developers and researchers applaud the changes, including dropping "coverage with evidence development" approach.
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Proposed reimbursement decision to be released 1 January 2022, with a final decision the following April. Biogen's Aduhelm expected to be covered in the interim. Medicare will not consider the cost of treatment in the analysis, but cost may have been a factor in initiating the process.
Biogen/Eisai’s newly-approved Alzheimer’s drug could be headed to CMS’ Medicare advisory committee, which is chaired by vocal drug pricing reform advocate Peter Bach.
Medicare may look to bolster evidence on Biogen’s potential Alzheimer’s treatment, if approved, with a national coverage decision requiring the collection of clinical data in the postmarket setting.