HHS: CMS Must Review Part B Fees After Aduhelm Price Cut

Department of Health and Human Services Secretary Xavier Becerra instructed Medicare regulator to revise its Medicare Part B premium recommendation for 2022 Monday morning, given the recent drop in the price of controversial Alzheimer’s drug Aduhelm.

The Centers for Medicare and Medicaid announced in November that Part B premiums will increase by 15%, citing a potential cost increase due to Aduhelm. Experts predicted that, at its original cost, Aduhelm would cost Medicare $ 29 billion a year if Medicare approves it.

But Biogen, the manufacturer of Aduhelm, announced last month that it would cut the price of therapy from $ 56,000 per patient per year to $ 28,200 to increase the number of prescriptions for the drug.

The FDA approved Aduhelm in June, despite questionable evidence that the drug is effective in treating Alzheimer’s disease. Several health systems have refused to prescribe it.

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CMS is going to publish a preliminary decision on whether Medicare will cover Aduhelm by this Wednesday, and a final decision by April.

“With the price of Aduhelm dropping 50% on January 1, CMS has good reason to revise its previous recommendation,” Becerra said in a statement.

Lawyers and lawmakers last month urged CMS to cut insurance premiums, saying there were even fewer excuses for the hike following the price drop for Aduhelm.

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