STAT May 25, 2023
Kerry Dooley Young

This article is adapted from the latest STAT Report: Decoding Medicare: 10 key coverage decisions and how they’re made.

Medicare’s decision to withhold coverage for Biogen’s Aduhelm despite the Food and Drug Administration’s approval of the Alzheimer’s drug has revived longstanding questions about how the federal program determines whether it will pay for new drugs and devices.

In its decision, the Centers for Medicare and Medicaid Services cited a lack of sufficient evidence for Aduhelm’s effectiveness, and limited payment for the drug to patients enrolled in research studies. The agency said it would apply the same limits to other new Alzheimer’s drugs that, like Aduhelm, target amyloid plaques in the brain.

The move has drawn strong praise from some. But...

Today's Sponsors

LEK
ZeOmega

Today's Sponsor

LEK

 
Topics: Biotechnology, Insurance, Medicare, Pharma, Pharma / Biotech
For Rural ACOs, New Primary Care Model From CMS Offers Much-Needed Financial Help
Sanders sounds alarm on US 'crisis in dental care'
Paul Kelly on PBM Reform as a Means to an End: A 'Pay For' for Telehealth Flexibilities
More Money, Fewer Prior Auths Needed to Save Private Practices, Lawmakers Told
Easier Access to Pot May Revolutionize Health Care for Seniors

Share This Article