Democratic and Republican attorneys general in nearly half of US states are calling on Medicare to provide unrestricted coverage of antibody treatments for Alzheimer’s disease. letter issued on monday
Attorneys general from 23 states, the District of Columbia, and two US territories have come under increasing pressure on the federal Centers for Medicare and Medicaid Services, or CMS, to end a controversial policy that severely restricts access to new drugs. Does Christian And biogenLekembi is
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lakenbi has shown to slow the progression of early Alzheimer’s to more advanced stages of the brain-wasting disease. Medicare’s decision to restrict coverage means that only wealthy seniors can pay up to $26,500 per year out of pocket.
The attorneys general, led by Gentner Drummond of Oklahoma, wrote to CMS, “We want CMS to provide full and unrestricted Medicare coverage for FDA-approved Alzheimer’s treatments, which is consistent with its policy of covering FDA-approved drugs for Medicare beneficiaries.” This is in line with decades-long practice.” Administrator Chiquita Brooks-Lasur and Health Secretary Javier Becerra.
The attorney general acknowledged that Lakenby is associated with some side effects, such as swelling and bleeding in the brain, but said that families and their doctors can weigh these risks against the benefit to patients, who can support their loved ones over the long term. able to recognize.
In a country with deep political divisions, the pressure to provide wider access to Alzheimer’s treatment is one of the few issues that can rally both sides of the aisle. More than 70 lawmakers from the House and 18 senators met Treatment To provide unrestricted coverage for Alzheimer’s treatment in Feb.
The push by members of Congress and state attorneys general came after Medicare denied the Alzheimer’s Association’s request to cover Lakenby unconditionally.
“After careful review of the request and supporting documentation, we are making this decision because as of the date of this letter, there is not yet evidence that meets the criteria for reconsideration,” CMS said in February.
Unlike Medicare, the Veterans Health Administration agreed to cover Lekambi for veterans age 65 and older who meet certain eligibility criteria.
Lakenby received early approval from the Food and Drug Administration in January. Under its current policy, Medicare will only cover antibody treatments that receive early approval for patients participating in clinical trials. Eisai’s trial has ended, meaning most seniors don’t have access to the drug.
The attorney general said the decision puts older Americans living in rural areas at a disadvantage, as clinical trials are typically conducted in large cities away from small towns.
“Travelling to some of the research institutions hosting the trials is an enormous physical and financial burden for Medicare beneficiaries,” the attorney general said. “Patients, families and caregivers living in rural and under-served areas should have equal opportunities for treatment.”
The language of the letter is similar to letters sent to Medicare by House lawmakers and senators in February.
Medicare has agreed to provide broad coverage of LeKenbi once it receives full FDA approval on July 6. Brooks-Lasur promised Congress last week that these registries would not restrict access to the treatment.
But Robert Egg, chief policy officer for the Alzheimer’s Association, told CNBC that registries will restrict access regardless of what Medicare has promised. He said the association was not aware of any concrete work being done to set up the registries.
Brooks-Lasur said private-sector entities can begin setting up the registries now.
The attorney general said the cost of Alzheimer’s disease and other forms of dementia was US$321 billion in 2022, a huge financial burden on federal health insurance programs. The attorney general said Medicare and Medicaid would pick up an estimated 67% of health care costs for the disease in 2021, or $239 billion.
The attorney general said, “Unless a treatment to slow, stop or halt the disease is approved and accessible to the public by 2050, the total cost of Alzheimer’s could exceed $1 trillion (in 2022 dollars).” is expected to reach.
The letter was signed by the attorneys general of Arizona, Arkansas, Connecticut, the District of Columbia, Florida, Idaho, Indiana, Maine, Michigan, New Hampshire, New Jersey, New Mexico, North Dakota, the Northern Mariana Islands, Minnesota, Ohio. Oklahoma, Oregon, Pennsylvania, Puerto Rico, South Carolina, Texas, Utah, Vermont, Virginia, and West Virginia.
Correction: This story has been updated to correctly reflect the following quote from the attorney general’s letter: “We want CMS to provide full and unrestricted Medicare coverage for FDA-approved Alzheimer’s treatments that the FDA covers.” consistent with its decades-long practice of providing approved prescription drugs for Medicare beneficiaries.” “It is a huge physical and financial burden for Medicare beneficiaries to travel to some of the research institutions hosting the trials.” “Patients, families and caregivers living in rural and under-served areas should have equal opportunities for treatment.” “Unless a treatment to slow, stop or halt the disease is approved and accessible to the public, the total cost of Alzheimer’s is estimated to reach $1 trillion (in 2022 dollars).” The previous edition inadvertently omitted parts of the quotes.
