
CMS Says It Will Limit Biogen’s AD Drug to Patients in Clinical Trials
In a National Coverage Determination decision memo released Tuesday, CMS said it will gather public comment for 30 days about its plan to limit coverage for Alzheimer disease (AD) biologics that target plaque buildup in the brain to patients enrolled in certain clinical trials.
CMS Tuesday announced it would only cover Alzheimer disease (AD) drugs like Biogen’s biologic for
In the National Coverage Determination (NCD) decision memo released Tuesday, CMS said it will gather public comment for 30 days and expects to make a final decision by April 11. Besides aducanumab, the NCD would also cover other similar monoclonal antibodies approved by the FDA through coverage with evidence development (CED)–meaning enrollment in qualifying clinical trials—that work the same way, by targeting the buildup of amyloid beta plaques in the brain.
“Alzheimer’s disease is a devastating illness that has touched the lives of millions of American families. Throughout this National Coverage Determination process, CMS has been and remains committed to providing the American public with a clear, trusted, evidence-based decision that is made only after a thorough analysis of public feedback on the benefits and risks of coverage for Medicare patients,” said CMS Administrator Chiquita Brooks-LaSure
If the
The price of the infused biologic was initially set at $56,000 annually, but Biogen cut the price by 50%
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