Medicare Limits Payments For Alzheimer’s New Drug To Trial - medtigo


Medicare Limits Payments For Alzheimer’s New Drug To Trial

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People with Alzheimer’s had a small hit back when the federal agencies decided to limit coverage for a new medication for the disease. The federal government announced yesterday that it would limit the coverage of the expensive medication to the people enrolled in the clinical trial. 

As per the Centers for Medicare and Medicaid Services (CMS), it would limit the payments for the drug to people involved in the clinical trial of a new drug. This information came out despite the Food and Drug Administration’s approval. 

A sigh of relief for Alzheimer’s patients is that the CMS said if the FDA approves future drugs in a more traditional way, it will allow the agency to have wider access to coverage for the medications. Moreover, those drugs would target the amyloid plaques that cause devastating effects of Alzheimer’s, as reported by the Washington Post. 

According to the decision, the drug Aduhelm will remain unavailable to Alzheimer’s patients who had hoped to try it for dementia or mild cognitive impairment. The target population of the drug is estimated to be 1 million to 2 million. Moreover, it is the first treatment intended to slow cognitive decline. 

The chief medical officer and director of the Center for Clinical Standards and Quality CMS said that there is not enough evidence to prove if Aduhelm is necessary for people with Medicare. 

In 2020, Alzheimer’s was the seventh most common cause of death in the US. 

The decision of CMS was also influenced by the fact that some popular health systems refused to offer medication developed by the drugmaker Biogen. Many healthcare experts doubt its efficacy. Moreover, the watchdog group  Public Citizen called for the resignation of top FDA officials for their carelessness, the Washington Post reports. 

Alzheimer’s advocacy groups fiercely fought CMS’s proposed coverage restriction when it was announced in January, angered that it would drastically limit the number of people who could receive the treatment. 


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