Medicare will cover monoclonal antibodies that target amyloid (or plaque) for the treatment of Alzheimer’s disease CMS, as a part of this decision, will provide enhanced access and coverage for people with Medicare participating in CMS-approved studies, such as a data collection through routine clinical practice or registries.
This decision is specific to individuals who have a clinical diagnosis of mild cognitive impairment due to Alzheimer’s Disease or mild dementia with a confirmed presence of plaque on the brain.
Editorial Note: I think this is a good decision. FDA’S advisory committee urged former FDA Commissioner Woodcock not to approve Aduhelm because the data were unclear whether the drug is effective. This approach will allow for data collection to determine whether it actually works. It will also cut down on the enormous drain that would have occurred to the Medicare Trust Fund that would have occurred given that the drug costs a whopping $56,000 per year per patient.
