Medicare limits coverage of unproven $28,000-a-year Alzheimer's drug; HHS considers refunding the overcharge

[sharon sanders]

bump this

[Emily]

This bold attempt to predate the nation's seniors has been beaten back for now.

https://www.king5.com/article/news/nation-world/medicare-limits-alzheimer-drug-aduhelm-coverage/507-3f8f817e-3b10-46cb-9565-8fe8138b1e02

Medicare limits coverage of $28,000-a-year Alzheimer's drug

For Medicare to pay, patients will have to be part of clinical trials to assess Aduhelm’s effectiveness against early-stage dementia and its safety.
Author: RICARDO ALONSO-ZALDIVAR Associated Press
Published: 6:09 PM PST January 11, 2022
Updated: 6:09 PM PST January 11, 2022

WASHINGTON —
Medicare said Tuesday it will limit coverage of a $28,000-a-year Alzheimer’s drug whose benefits have been widely questioned, a major development in the nation’s tug-of-war over the fair value of new medicines that offer tantalizing possibilities but come with prohibitive prices.

The initial determination from the Centers for Medicare and Medicaid Services means that for Medicare to pay, patients taking Biogen’s Aduhelm medication will have to be part of clinical trials to assess the drug’s effectiveness in slowing the progression of early-stage dementia as well as its safety. Medicare’s national coverage determination would become final by April 11, following a public comment period and further evaluation by the agency.

...
Biogen's initial launch price of $56,000 a year for Aduhelm led to an increase of nearly $22 in Medicare’s monthly “Part B” premium for outpatient care, the largest ever in dollar terms but not percentage-wise. Medicare attributed about half of this year’s increase to contingency planning for Aduhelm. Faced with skepticism over its medication, Biogen recently slashed the price to $28,200, but Medicare enrollees were already on the hook for the $170.10 premium. Health and Human Services Secretary Xavier Becerra has directed Medicare to reassess the premium increase...