Medicare/Medicaid Denies Coverage For Promising, Expensive Alzheimer’s Drug

Statewide Iowa — Advocates in Iowa are stunned over the decision by the Centers for Medicare and Medicaid Services, or CMS, to deny coverage for an entire class of drugs to treat Alzheimer’s disease.

Lauren Livingston, spokeswoman for the Iowa Chapter of the Alzheimer’s Association, says the blanket decision has tremendous implications beyond the initial drug, Aduhelm.

The draft decision says all future FDA-approved treatments in this class of drugs, regardless of clinical trial results and what the FDA recommends, will NOT be covered except in another clinical trial.

Aduhelm is showing promise in the treatment of early-stage Alzheimer’s and for others with mild cognitive impairment. For CMS to deny coverage, Livingston says, is putting concerns about money over the lives of patients.

Many other drugs used in treating other afflictions are quite expensive and ARE covered by CMS, she notes. A statement from the national association’s CEO says: “People living with Alzheimer’s disease deserve the same access to therapies given to those living with other conditions like cancer, heart disease and HIV/AIDS. For those in the Administration to treat those with Alzheimer’s disease differently than those with other diseases is simply unacceptable.” About six-million Americans are living with Alzheimer’s, including some 66-thousand Iowans.

You can visit the Iowa Alzheimer’s Association at alz.org/iowa.

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