Medicare is being asked by U.S. health secretary Xavier Becerra to reassess a price hike on premiums that was introduced to cover the increased cost of the Alzheimer's drug Aduhelm. Initially, drug manufacturer Biogen
In one of the biggest annual increases ever, Medicare's standard premium will increase by $22 this year. The high price of Aduhelm was the reason for $11 worth of that increase.
"With the 50% price drop of Aduhelm on Jan. 1, there is a compelling basis ... to reexamine the previous recommendation," Becerra said in a directive to the Centers for Medicare and Medicaid Services.
The earliest that Medicare recipients should expect to see a reduction in their premium is later in the year. This means they will be paying the higher $170.10 per month in the meantime, despite the fact that $11 worth of that price is no longer justified, based on officials' explanations of its initial attribution.
In mid-December, Democratic Senators called on Becerra, as well as President Joe Biden, to act immediately to address the skyrocketing prices of prescription drugs. Currently, legislation that would restrict the annual cost of Medicare to $2,000 is currently bogged down in Congress, along with the rest of Biden's agenda.
In its announcement of the halved price, Biogen acknowledged the prohibitively high initial price of Anduhelm.
"Too many patients are not being offered the choice of Aduhelm due to financial considerations and are thus progressing beyond the point of benefitting from the first treatment to address an underlying pathology of Alzheimer's disease," CEO Michel Vounatsos said. "We recognize that this challenge must be addressed in a way that is perceived to be sustainable for the U.S. healthcare system."
Coverage of Anduhelm is tightly restricted under Medicare, with cases being decided one at a time. An initial coverage decision is expected, but that coverage decision won't be finalized for months.
Because Anduhelm is administered in-office, it's processed by Medicare differently than other prescriptions. While the high cost of prescriptions for serious medical conditions like cancer usually falls on the patient themselves, due to this difference in its category, the cost of Anduhelm coverage is more dispersed amongst policyholders. This means that the cost of this one drug is able to affect the premiums for everyone.
Anduhelm is the first Alzheimer's drug that has been introduced in nearly two decades. It can't treat the condition, but it may be able to slow its progression. Experts say this effect has not been demonstrated.