Medicare Proposes to Cover Aduhelm Only for Patients in Clinical Trials
The New York Times
If the preliminary decision is finalized this spring, it would sharply limit the number of patients who use the expensive drug.
Medicare officials have decided that the federal health insurance program should only cover the controversial new Alzheimer’s drug Aduhelm for patients who are participating in approved clinical trials. If the preliminary decision is finalized later this year, it would significantly limit the number of patients who could use the expensive drug.
The decision, reached after lengthy deliberations, was released on Tuesday by the Center for Medicare and Medicaid Services, or C.M.S. It said that coverage should be provided for patients in “C.M.S. approved randomized controlled trials” and trials supported by the National Institutes of Health. “All trials,” it said, “must be conducted in a hospital-based outpatient setting,”
The agency added that Aduhelm or other similar drugs for Alzheimer’s that are provided outside of these trials “are nationally non-covered.”