Medicare told to reassess premium hike for Alzheimer’s drug

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US Health Secretary Javier Becerra is ordering Medicare to reevaluate a huge premium hike facing millions of seniors this year

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Becerra’s directive comes days after drugmaker Biogen slashed the price of its $56,000-a-year drug, EduHelm, to $28,200 a year — nearly half.

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“The 50% drop in EduHelm prices on Jan. 1 is an imperative basis for re-examining the previous recommendation,” Becerra said in a statement to the Centers for Medicare and Medicaid Services regarding its directive. The statement was provided to The Associated Press.

More than 50 million Medicare recipients who pay $170.10 monthly “Part B” premiums for outpatient care will see no immediate change in their costs, but Monday’s move could open the way for a reduction later in the year. The Department of Health and Human Services says it is reaching out to the Social Security Administration, which collects premiums, to investigate options.

Standard Part B premiums are rising by about $22 this year, up from $148.50 in 2021 and one of the biggest annual increases ever. About half of that, $11, is attributed to potential costs to cover Aduhelm at its original $56,000 price.

Becerra’s move came after prominent Democratic senators urged the Biden administration to take immediate steps to cut rising drug costs for senior citizens. Big restrictions on drug prices promised by Democrats hang with the rest of President Joe Biden’s largely social agenda legislation in Congress.

In announcing the price cut a few days before the Christmas holidays, Biogen acknowledged that high costs have become a major deterrent to taking its drug.

Medicare is currently covering EduHelm on a case-by-case basis. Later this week, the agency is expected to issue a preliminary coverage decision, but the process to finalize it could take months.

Generally, the financial impact of high-cost drugs is greatest for patients with serious diseases such as cancer, rheumatoid arthritis or multiple sclerosis. But with EduHelm, the pain will generally be spread among Medicare recipients, not just Alzheimer’s patients needing the drug.

It has turned medicine into a case study on how a costly treatment can spin the needle on government spending and overwhelm the household budget. People who do not have Alzheimer’s will not be shielded from the cost of EduHelm, as it is large enough to affect their premiums.

Alzheimer’s is a progressive neurological disease with no known cure, affecting approximately 6 million Americans who are old enough to qualify for Medicare.

Aduhelm is the first Alzheimer’s drug in nearly 20 years. It doesn’t cure a life-long condition, but the Food and Drug Administration has determined that its ability to reduce plaque buildup in the brain may slow dementia in its early stages. However, many experts say the benefit has not been clearly demonstrated.


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