Draft Ruling from CMS Suggests Narrow Coverage for Aduhelm

January 12, 2022

The Centers for Medicare & Medicaid Services (CMS) have released a draft ruling indicating it will only cover Biogen’s Alzheimer’s drug Aduhelm for patients in clinical trials. This ruling will have a stark financial impact on Biogen if it becomes final guidance, as older individuals, the largest market for the drug, rely heavily on Medicare.

In a Fierce Pharma article, Angus Liu writes, “The requirement of a clinical trial as a condition for reimbursement—known as coverage with evidence development (CED)—would create “more logistical, administrative and other roadblocks” to getting Aduhelm, Jefferies analyst Michael Yee said in a separate note. It would limit access to no more than several thousands of patients, SVB Leerink analyst Marc Goodman pointed out in his note. By contrast, Biogen had estimated roughly 50,000 patients could start treatment this year if a Medicare reimbursement policy were in place.”

Click here to read more.

(Source: Fierce Pharma, January 12th, 2022)

Share This Story!