But even though the FDA allowed the drug to be sold, Medicare is not required to pay for it. And yesterday, the Centers for Medicare & Medicaid Services (CMS) began a process to determine whether Medicare will establish a national coverage policy for the newly approved drug, Biogen’s Aduhelm (aducanumab), and similar Alzheimer’s drugs. It will result in national guidance about whether Medicare will pay for the drug and under what circumstances. If only 1 million are prescribed the drug, Medicare costs could exceed $50 billion annually. Even if Medicare decides to pay, patients generally would be responsible for 20 percent plus the cost of required testing and imaging that Medicare does not cover.

Source: Forbes July 13, 2021 17:57 UTC