Medicare in November raised the Part B premium, which covers physician and outpatient hospital services, by 15% to $170.10 in 2022, with uncertainty around the coverage decision for the treatment, Aduhelm, one of the drivers behind the increase.
The U.S. Food and Drug Administration approved Aduhelm in June to treat the brain-wasting disease despite the view of its outside advisory panel that Biogen had not proven the treatment’s clinical benefit.
Last month, the drugmaker cut the price of Aduhelm to $28,200 for an average weight person after facing slower-than-expected U.S. sales on complaints from hospitals that its high cost was not worth its benefits.
“With the 50% price drop of Aduhelm on January 1, there is a compelling basis for CMS to reexamine the previous recommendation,” Beccera said in a statement.
The U.S. Medicare program, which pays for health services for people over 65 years, has scheduled a meeting this month for a national policy for the drug.
“We have spoken with majority of payers and the price change was very well received by both payers and physicians,” said Alisha Alaimo, president of Biogen’s U.S. operations, at the annual J.P Morgan Health Care conference on Monday.
“We have heard anecdotal cases of physicians calling patients back who are hesitant because of the price.”
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