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.
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Typically, state intervention in pharmaceuticals is aimed at drug cost control which, if taken to extremes, can border on nationalism.
Company execs say there has been four-fold increase in doctors infusing the Alzheimer’s drug and despite lack of support from major institutions, individual physicians at Cleveland Clinic and elsewhere have voiced support for Aduhelm. Biogen is “cautiously optimistic” about lecanemab Phase III trial.
Company discusses its strategy for negotiating a change in the recently-proposed Medicare coverage decision for Alzheimer’s drugs during a presentation to analysts.