Medicare asks for review of premium increases for Alzheimer’s drugs



US Health Secretary Xavier Becerra on Monday ordered Medicare to reassess the massive premium increases faced by millions of seniors this year, largely due to an expensive new Alzheimer’s drug. money with questionable benefits.

Becerra’s directive comes days after drug maker Biogen slashed the price of its drug Aduhelm by $56,000 a year to $28,200 a year – a cut of about half.

“With Aduhelm’s 50% discount on January 1, there is compelling grounds… for reconsidering the previous recommendation,” Becerra said in a statement of its directive to the Centers for Medicare and Medicaid Services. . The statement was provided to the Associated Press.

More than 50 million Medicare recipients who pay a monthly $170.10 “Part B” premium for outpatient care won’t have an immediate change to their costs, but Monday’s move could pave the way for cuts at the end of the year. The Department of Health and Human Services said it is contacting the Social Security Administration, which collects premiums, to review options.

Standard Part B premiums are growing by about $22 this year, up from $148.50 in 2021 and one of the biggest annual increases ever. About half of that, $11, was attributed to the potential cost of having to cover Aduhelm with its initial $56,000 price tag.

Becerra’s move comes after prominent Democratic senators urged the Biden administration to take immediate steps to cut soaring drug costs for the elderly. The larger drug price restrictions promised by Democrats will hang in Congress along with the rest of President Joe Biden’s major social program act.

When it announced the price cut just days before the Christmas holidays, Biogen admitted the high cost had become an obstacle to its drug purchases.

CEO Michel Vounatsos said: “Too many patients are not offered the Aduhelm option due to financial considerations and are therefore progressing beyond the benefit of the first treatment to address their underlying medical condition. Alzheimer. “We recognize that this challenge must be addressed in a way that is considered sustainable for the U.S. health care system.”

Medicare currently covers Aduhelm on a case-by-case basis. By the end of this week, the agency is expected to make a decision on initial coverage, but finalization could take months.

Often, the financial impact of high-cost drugs will most directly affect patients with serious illnesses such as cancer, rheumatoid arthritis or multiple sclerosis. But with Aduhelm, the pain will be widespread among Medicare recipients in general, not just Alzheimer’s patients who need the drug.

That has turned the drug into a case study of how an expensive treatment can prick government spending and impact household budgets. People without Alzheimer’s won’t be protected from Aduhelm’s costs, as it’s large enough to affect their premiums.

Alzheimer’s is a progressive neurological disease with no cure that affects about 6 million Americans, the vast majority of whom are old enough to qualify for Medicare.

Aduhelm is the first Alzheimer’s drug in nearly 20 years. It doesn’t cure dementia, but the Food and Drug Administration has determined that its ability to reduce plaque clumps in the brain has the potential to slow dementia in its early stages. However, many experts say that benefit remains unproven.

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