Aduhelm Overkill: Broad Medicare Policy Is Unreasonable – And Unnecessary

Medicare has clearly won the battle when it comes to prevent the Alzheimer’s therapy Aduhelm from consuming billions in taxpayer spending based on data that the payor agency finds unconvincing. But in finalizing a policy that has broad implications for all FDA approved therapies, it may be starting a war that it cannot win.

CMS chess brain
Did CMS overthink its Alzheimer's NCD? • Source: Nielsen Hobbs; the Pink Sheet | Alamy images

The US Centers for Medicare & Medicaid Services is taking a remarkable stance in its final coverage policy on beta amyloid targeted Alzheimer’s therapy.

The agency is asserting that its coverage standard – whether a drug is “reasonable and necessary” for the Medicare population – would not be met by a product that received a traditional approval (i.e

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