The Centers for Medicare and Medicaid Services has announced that it will only cover the controversial Alzheimer’s therapy Aduhelm for Medicare patients who are in clinical trials.
Besides setting clear-cut rules for when Medicare will cover the drug, it also sets the stage for the CMS to reduce Medicare Part B premiums as a result of the decision.
Premiums for Medicare Part B rose 15% this year from 2021 in part because Medicare expected to cover the drug without restrictions when setting rates for 2022.
Under the rules, finalized in April 2022, Medicare beneficiaries who are in clinical trials overseen by the CMS, the Food and Drug Administration or the National Institutes of Health, will be covered for Aduhelm. Medicare Alzheimmer’s Drug Decision and Its Effect on Rates, Coverage