Health payers –including Medicare and Point32Health–to question Aduhelm pricing and its “reasonable and necessary” use

State’s Second-Largest Health Insurer Slams Biogen For Costly Alzheimer’s Drug (The Boston Globe): The state’s second-biggest health insurer is threatening to limit or not cover Biogen’s new Alzheimer’s drug, accusing the Cambridge biotech of putting “excessive corporate profits” ahead of patients by charging $56,000 a year for the controversial treatment. Michael Sherman, chief medical officer for Point32Health, the insurance company formed by the recent merger of Tufts Health Plan and Harvard Pilgrim Health Care, said Biogen should cut the cost of the drug called Aduhelm by a factor of roughly 10, to $5,400, given the medicine’s questionable benefits and potential risks. Senators Call On Congress To Examine Expensive New Alzheimer’s Drug (STAT): Sens. Elizabeth Warren (D‑Mass.) and Bill Cassidy (R‑La.) want Congress to take a deeper look at how Biogen’s controversial and pricey new Alzheimer’s drug, Aduhelm, will affect the Medicare program, they wrote in a letter Wednesday. The bipartisan duo is pressing the Senate Finance Committee to take on “the vexing new questions and challenges that approval raises for the Medicare program and other health programs” the panel oversees, they wrote. The Letter from Sens. Elizabeth Warren (D‑Mass.) and Bill Cassidy (R‑La.): Cassidy, Warren Call for Hearing on New Alzheimer’s Disease Drug Aduhelm (press release): … Under the broad label that FDA approved, the drug is available to all Alzheimer’s p...
Source: SharpBrains - Category: Neuroscience Authors: Tags: Brain/ Mental Health Aduhelm Alzheimer's drug amyloid PET scans Biogen Centers for Medicare and Medicaid Services clinical efficacy Point32Health Source Type: blogs