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After Biogen said on Monday that it would reduce its Part B premiums in 2022, patient advocates and Democratic lawmakers hope that Medicare will reduce its Part B premiums. controversial Alzheimer’s disease drug Aduhelm is halved.
According to Juliette Cubanski, deputy director of the Medical Insurance Policy Program of the Caesars Family Foundation, the Medicare and Medicaid Services Center did not change the premiums afterwards. But that doesn’t mean they can’t, she said.
“This will be an unprecedented move, but I don’t think it will be an unfounded move, because a large part of the increase in 2022 is due to the price of this drug,” she said.
Michel Vounatsos, CEO of Biogen, said that Biogen is reducing the price of its treatments after discovering that suppliers are not providing medicines to patients at the speed the company hopes. The therapy aims to slow the progression of Alzheimer’s disease, from US$56,000 per patient per year to US$28,200 per year. Press Releases. As of September, only about 100 patients took Aduhelm, according to To STAT.
The US Food and Drug Administration approved Aduhelm in June, although there is evidence that the drug is effective in treating Alzheimer’s disease. CMS plans to make preliminary recommendations in the following areas Should medical insurance be covered Aduhelm before January 12.
CMS announced a Increase by 15% In the beneficiary’s 2022 medical insurance Part B premiums, Aduhelm cited the potential cost of the plan as the reason for the increase. Based on the original price, experts predict that Aduhelm will spend $29 billion on medical insurance annually.
Beneficiary advocates have called for CMS to reduce premiums.
“If they don’t reverse this situation… then as a beneficiary of health insurance, I would be very unhappy,” said George Vradenburg, chairman and co-founder of UsAgainstAlzheimers, who supports CMS covered treatments.
Legislators including Senator Bernie Sanders (I-Vt.) and Senator Ron Wyden (D-Ore.) lead the powerful Senate Finance Committee, ask The Ministry of Health and Human Services restricts premium increases related to Aduhelm.
“As the price of Aduhelm drops, there are fewer reasons to plan to increase Medicare Part B premiums. When it comes to protecting the elderly, the government’s wheels must turn quickly,” Wyden said in a statement on Monday.
Cubanski said that CMS is unlikely to change the premium before January, if they do, because their actions may also depend on whether the medical insurance ultimately decides to cover Aduhelm.
In other words, the coverage is determined based on clinical results, not price. Richard Frank, director of the USC-Brookings Schaeffer Health Policy Initiative and former assistant secretary of HHS Planning and Evaluation, said that the price drop will not have much impact on whether medical insurance decides to cover Aduhelm. But he said the announcement raised concerns that Biogen may be easing their claims to Aduhelm.
Frank said: “My feeling is that considering its effects, it is still a problematic effective drug, with some bad-some very bad-side effects, which are related to very high prices.”
Kubanski said that if the plan does cover the drug, the price drop is good news for health insurance expenditures, and Wyden pointed out in his statement that if CMS decides to cover the drug, the health insurance finances will still be affected. Blow. Kubansky said whether the cuts will encourage more suppliers to open Aduhelm is an open question.
Several health systems and private payers, as well as the Department of Veterans Affairs, have Decided against Prescribe or cover drugs.
Kubansky said: “When doctors judge whether this drug is beneficial to patients, I don’t think the price is important.”
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