Medicare Coverage For Alzheimer’s Drugs Could Align With Degree Of Plaque Removal, Lilly Says
Company maintains that the upcoming Medicare national coverage policy for Alzheimer’s drugs should not impose the same access restrictions on drugs with better evidence of effectiveness than others.
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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.
The US FDA revised labeling to clarify the target population, which could be helpful in reimbursement discussions for the Alzheimer's therapy.
TRAILBLAZER-ALZ met the primary, but not most secondary endpoints. Lilly said efficacy of its amyloid-clearing agent depends on tau levels at baseline and reductions in some parts of the brain.