Of Price And Premiums: Medicare Has Put Alzheimer’s Drug Sponsors On Notice
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.
You may also be interested in...
Donanemab results due next year have a good chance of persuading CMS to offer unrestricted coverage, Lilly argues, even though the drug might just have accelerated approval at that point. ‘We believe that having two positive pivotal trials should meet that high level of evidence.’
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.
Final Medicare national coverage determination aims to set up a ‘nimble’ system to allow for broad and rapid patient access to drugs for Alzheimer’s disease following traditional approval while retaining a more restrictive approach for accelerated approvals.