Medicare Coverage For Alzheimer’s Drugs: CMS Declines To Revise Restrictions For Class

Medicare coverage restrictions are more likely to be reconsidered on a case-by-case basis as drugs in the class obtain traditional US Food and Drug Administration approvals in the coming months.

Was the Broad Request For Reconsideration An Overreach? • Source: Shutterstock

The Centers for Medicare and Medicaid Services is not ready to reconsider its national coverage determination that conditions Medicare reimbursement for amyloid-directed Alzheimer’s drugs on use within a study, the agency told the Alzheimer’s Association.

The clinical benefit of a promising drug in the class, Eisai Co., Ltd./Biogen, Inc

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