Medicare to Cover New Alzheimer's Rx

Medicare says it will cover new Alzheimer’s drug Aduhelm (aducanumab)

(RxWiki News) The Centers for Medicare & Medicaid Services (CMS) has announced that Medicare will cover a new Alzheimer's drug.

The decision to cover Aduhelm (aducanumab) came after months of debate over whether Medicare should cover the highly priced new treatment.

It's important to note that this decision is not final, but Medicare has proposed that it should cover this and similar antiamyloid monoclonal antibody drugs for patients who are enrolled in randomized clinical trials that are CMS-approved or supported by the National Institutes of Health (NIH).

The decision for Medicare to cover Aduhelm will be finalized in April of this year, according to the Kaiser Family Foundation.

The debate over whether to cover the drug so far has centered on the effect of its high price tag on the Medicare Part B premium. Recently, Aduhelm maker Biogen announced that it would cut the price in half because demand for Aduhelm appeared low prior to the CMS decision.

The decision to reduce the price of Aduhelm is likely to soften the impact Aduhelm will have on Medicare spending, health officials said.

When the FDA approved Aduhelm in June of 2021, it was the first new Alzheimer's treatment approved in 18 years. Almost immediately, controversy surrounding the approval broke out.

The controversy centered on the FDA's approval of the drug in spite of the recommendation of its own advisory panel not to approve it. Three members of the panel resigned after the approval.

Additional concerns focused on the price of Aduhelm, which was set at $56,000 per year. Since then, Biogen reduced the price to $28,200 per year.

The mechanics of drug approvals and Medicare coverage can be confusing, but your health care provider can help. Ask your health care provider about the available treatments for Alzheimer's disease.

Review Date: 
February 2, 2022