Medicare Premium Hike Will Help Build ‘Contingency Fund’ For Alzheimer’s Drugs
But CMS cautions that the announcement should not be read as a preview of its upcoming national Medicare coverage decision on Aduhelm and similar treatments.
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Medicare will be closely watching for pricing decisions by Eli Lilly, Eisai and Roche once the companies gain US marketing approval for their amyloid-directed monoclonal antibody drugs for Alzheimer’s disease.
CMS took pains in its final national coverage determination to try to mend fences with FDA; how the NCD will play with Medicare recipients remains an open question, especially since the Alzheimer’s-induced premium hikes remain in effect.
Nearly 5,000 comments from individuals on CMS’ proposal to restrict coverage of Alzheimer’s drugs argue that Aduhelm should never have been approved and should not be covered. The outpouring is surprising in light of expectations there would be a flood of patient comments urging broader coverage.