Advocates concerned about denial of Alzheimer’s drug coverage

DES MOINES — 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, the spokeswoman for the Iowa Chapter of the Alzheimer’s Association, says the blanket decision has tremendous implications beyond the initial drug, Aduhelm. “They will require people who want to try out these treatments in the future to have to go through a clinical trial in order to receive the treatment,” Livingston says, “and the main problem is, this really restricts access to the majority of people.”

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. “They’ve never made a decision to cover an entire class of drugs based on just one drug,” Livingston says, “and many people aren’t even near an institution that does clinical trials, so it makes it really hard for people to get access to these treatments.”

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.

“Biogen, the drug maker, originally had it priced at $56,000,” Livingston says. “They did get a lot of pushback from the Alzheimer’s Association and many others and they did cut the price to $28,000 a year, but that’s still far too expensive for the majority of people to be able to afford out-of-pocket without coverage.”

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 66,000 Iowans.