Who Needs The BBB? Aduhelm Shows Medicare Price ‘Negotiation’ Is Already Here
Biogen is making clear that its decision to cut the price of the Alzheimer’s therapy Aduhelm is in no way tied to the upcoming US Medicare coverage decision for the treatment. But it still shows how Medicare can already ‘negotiate’ prices even without explicit statutory authority.
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Medicare will be closely watching for pricing decisions by Eli Lilly, Eisai and Roche once the companies gain US marketing approval for their amyloid-directed monoclonal antibody drugs for Alzheimer’s disease.
Even as the US FDA can expect to be put through the ringer with the congressional and HHS Inspector General probes, the process could have some upsides for the agency, according to former officials who have been through such scrutiny.
Critics of the US Centers for Medicare and Medicaid Services’ proposed decision to restrict Medicare coverage of Aduhelm and similar Alzheimer’s drugs have described the policy as an effort to ration treatments based on cost concerns. Even some supporters are connecting cost to the decision.