Medicaid Adoption Of Medicare CED Restrictions For Alzheimer’s Drugs Weighed By MACPAC
Medicaid advisory panel members suggest states should have the same flexibility as Medicare to adopt coverage with evidence development requirements for drugs with limited supporting evidence.
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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.
Final Medicare national coverage determination aims to set up a ‘nimble’ system to allow for broad and rapid patient access to drugs for Alzheimer’s disease following traditional approval while retaining a more restrictive approach for accelerated approvals.
As MACPAC moves toward formal recommendations, a CBO analysis finds that differential Medicaid rebates for drugs approved through the accelerated pathway could save the federal government up to $1bn over five years.