Medicare Officially Limits Coverage of Aduhelm to Patients in Clinical Trials

Xavier Becerra, secretary of health and human services, had said that he would consider lowering premiums after the final coverage decision for Aduhelm was made, adding that “We’re going to make sure that seniors don’t pay more than they have to.”

In the interview Thursday, Ms. Brooks-LaSure, the C.M.S. administrator, said “The secretary told us to look at it, and we are going to engage in the process of reviewing the Part B premium.”

Advocacy groups, several of which receive some funding from Biogen and other pharmaceutical companies, had campaigned vigorously for broad Medicare coverage. These groups said patients should be able to decide with their doctors whether to try an F.D.A.-approved drug and claimed it was discriminatory to only reimburse participation in clinical trials that may not be easily accessible to many patients.

“We just can’t let it stand as it is,” Harry Johns, the chief executive of the Alzheimer’s Association, told the organization’s staff, according to a recording of the meeting obtained by The New York Times.

In an interview before the Medicare announcement, Mr. Johns indicated that the association wouldn’t be satisfied if Medicare’s restrictions applied only to Aduhelm, saying, “We absolutely believe there is sufficient evidence to provide coverage for the first approved treatment.”

Article source: https://www.nytimes.com/2022/04/07/health/aduhelm-medicare-alzheimers.html