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Medicare And Alzheimer’s Drugs: Recent NCDs Mainly Omit Research Requirement, Biogen Notes

Executive Summary

Biogen suggests potential precedents in past coverage decisions for upcoming Medicare determination on Aduhelm and other amyloid-directed monoclonal antibodies during earnings call.

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Medicare Draft NCD For Alzheimer's Drugs: When 'Reasonable And Necessary' And 'Safe And Effective' No Longer Align

Proposed decision withholds Medicare coverage from current and future amyloid-directed monoclonal antibody drugs for Alzheimer’s disease unless patients are enrolled in a randomized clinical trial.

Aduhelm Price Cut May Help Pave The Way For Medicare National Coverage Determination

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.

Biogen Halves Aduhelm Price, Readies $500m In Cost Cuts

The Alzheimer’s drug’s price was cut to $28,200 per year just one month before CMS is expected to issue a draft national coverage determination for amyloid-clearing antibodies, raising questions about the timing.

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