Wednesday, January 12, 2022
Last fall I had blogged about the significant increase in the Medicare Part B premiums for 2022. Part of the increase was due to the cost of the new Alzheimer's drug. There have been developments since the Part B premium was announced. Here are a couple. First, the AP reported on January 10, 2022 that Medicare told to reassess premium hike for Alzheimer's drug.
" U.S. health secretary Xavier Becerra on Monday ordered Medicare to reassess a big premium increase facing millions of enrollees this year, attributed in large part to a pricey new Alzheimer’s drug with questionable benefits. [This] came days after drugmaker Biogen slashed the price [about in half]." Based on that cut, the Secretary determined that a review of the 2022 premium was appropriate. This is no guarantee that the Part B premium will be reduced, but the article notes that beneficiaries will [not] see [an] immediate change to their costs, but Monday’s move could open the way for a reduction later in the year. The Department of Health and Human Services says it is reaching out to the Social Security Administration, which collects the premium, to examine options."
Second, Kaiser Health News included summaries of stories from several news outlets regarding the decision by CMS regarding coverage of the new Alzheimer's drug Medicare To Limit Coverage Of Contentious And Costly Alzheimer’s Drug. For example, the AP story, Medicare limits coverage of $28,000-a-year Alzheimer’s drug, "The initial determination from the Centers for Medicare and Medicaid Services means that for Medicare to pay, patients taking Biogen’s Aduhelm medication will have to be part of clinical trials to assess the drug’s effectiveness in slowing the progression of early-stage dementia as well as its safety. Medicare’s national coverage determination would become final by April 11, following a public comment period and further evaluation by the agency." The drug manufacturer disagrees with the decision.
So what will be the impact of the price drop, the reassessment and the coverage decision? Stay tuned.