Medicare May Rethink Premium Hike for Pricey Alzheimer’s Drug

MONDAY, January 10, 2022 — Medicare has been asked to reassess a significant premium increase it had said stemmed in large part from the new, expensive Alzheimer’s drug, Aduhelm.

US Health and Human Services Secretary Xavier Becerra’s directive, announced Monday, comes shortly after Aduhelm-based manufacturer Biogen slashed the drug’s price by nearly half, from $56,000 to $28,000 a year.

“With the price of Aduhelm down 50% on January 1, there is a compelling basis… to re-examine the previous recommendation,” Becerra said in a statement.

The premium for the standard segment B is set to increase by about $22 this year, up from $148.50 in 2021. It will be one of the largest annual increases ever. About $11 of the increase is attributable to the potential costs of having to cover Aduhelm at its original $56,000 price.

There will be no immediate change in premiums for the more than 50 million Medicare recipients who pay $170.10 per month Part B premium for outpatient care, but Besira’s request to the US Centers for Medicare and Medicaid Services (CMS) may result in a reduction later in the year, and News agency mentioned.

In June, the US Food and Drug Administration’s approval of Aduhelm (aducanumab) sparked a backlash from the medical community because clinical trials showed the drug does not lead to any visible improvement in brain function. It also came with safety concerns.

But groups like the Alzheimer’s Association have argued that Aduhelm’s success could pave the way for better treatments for memory-stealing disease.

“It was always an advance from the first treatments which was by no means everything we had hoped for, but it was an important first step leading to incremental progression, treatment by treatment, as we learned more and had more research and development,” Robert Ege told, Chief Policy Officer at the Alzheimer’s Association health day News last week. “This is the path we see ahead for Alzheimer’s disease.”

However, critics of the drug say CMS was essentially forced to correct a serious mistake the Food and Drug Administration made when it approved Aduhelm based on shaky evidence.

“The drug, in light of the available evidence, provides false hope for Alzheimer’s patients and their families,” said Dr. Michael Carrum, director of the Citizens Public Health Research Group. health day News. “The correct decision for CMS is not to cover the drug until there is sufficient evidence that the drug is working.”

When it announced the lower price of Aduhelm, Biogen acknowledged that the higher cost discouraged use of the drug by Alzheimer’s patients.

“Many patients are not being offered to choose Aduhelm due to financial considerations, and therefore are progressing beyond the point of benefiting from the first treatment to treat the underlying disease of Alzheimer’s disease,” Biogen CEO Michael Vonatsos said in a statement at the time. . “We recognize that this challenge must be addressed in a way that is seen as sustainable for the US health care system.”

Currently, Medicare covers Aduhelm on a case-by-case basis, but it is expected to announce an initial coverage decision later this week. AP mentioned. However, finalizing this decision could take months.

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