Medicare proposes covering expensive Alzheimer's drug for those in clinical trials

The headquarters of the Biogen Inc. is in Cambridge, Mass. The Alzheimer's drug will be limited by Medicare because of its questionable benefits.

Steven Senne.

The Alzheimer's drug Aduhelm would be covered by Medicare, but only for those participating in clinical trials.

The drug will only be available to Medicare recipients who are participating in approved clinical trials or the National Institutes of Health, according to the Centers for Medicare and Medicaid Services.

The drug is the first approved treatment to slow cognitive decline in people living with the disease. Medical experts and doctors have refused to prescribe it because there is no evidence that it slows memory loss.

Health care officials were concerned that the drug could strain Medicare's budget. Medicare premiums will increase this year due to anticipation of the drug's costs.

The administrator of the Centers for Medicare and Medicaid Services said that the agency has proposed an evidence-based coverage policy after experts reviewed all relevant publicly available evidence.

The proposal is expected to be decided by April.

The agency wants to hear from Americans with Alzheimer's, their family members and caregivers, patient advocacy groups, medical experts and others. A decision is expected by April 11.

The news of the drug's coverage comes a day after the Health and Human Services Secretary instructed the Centers for Medicare and Medicaid Services to reexamine the recommendation for the Medicare Part B premium.

There is a reason for the previous recommendation to be reexamined after the 50% price drop of Aduhelm on January 1.

Aduhelm is the first drug that can remove amyloid from the brain of Alzheimer's patients. It's the first new Alzheimer's drug in a decade.

The drug was granted approval by the FDA despite the advisory panel's recommendation against it.

Sales of the drug have been slower than expected. In the three months after its approval, Aduhelm brought in $300,000, which is a very low number for a drug with a previous price tag of $60,000 a year.

Alzheimer's is progressive and is an incurable condition according to the director of the Banner Sun Health Research Institute.

"I think we need to figure out a way to present that option to patients in a way that's safe," Atri said.