Medicare Coverage Analysis Of Alzheimer’s Drugs Begins With Focus On Outcomes, Patient Eligibility
Proposed reimbursement decision to be released by 12 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.
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With CMS draft decision expected next month on amyloid-clearing antibodies for Alzheimer’s, Biogen slashes Aduhem’s price 50% to $28,200 per year. Move reverses another aspect of the approval that drew criticism, including the expansive label and long horizon for confirmatory data.
CMS principal deputy administrator Jonathan Blum discusses how the agency is thinking about implementing the drug pricing reforms now under consideration in the US Congress.
US biopharma stakeholders are getting a taste of how a single payer health care system can shape the fate of a new treatment with Medicare’s national coverage determination for amyloid-directed Alzheimer’s drugs including Biogen/Eisai’s Aduhelm.