The Centers for Medicare and Medicaid Services, in a Jan. 11 proposed decision memo, proposes to cover an entire class of Alzheimer’s drugs only if beneficiaries are enrolled in a randomized control trial conducted in an outpatient hospital setting.
U.S. Sens. Mark R. Warner (D-VA) and Ed Markey (D-MA), co-chairs of the Congressional Task Force on Alzheimer’s Disease, and Sens. Chris Van Hollen (D-MD) and Debbie Stabenow (D-MI) are raising concerns with CMS over its plans for the drug Aduhelm and other similar Alzheimer’s treatments.
“Monoclonal antibody treatments that target amyloid plaques in the brain are the therapies farthest along in their potential for treating certain individuals with Alzheimer’s disease,” the senators wrote. “We are concerned that by including the entire class of drugs in this coverage decision—before final data on safety and efficacy are even released on other therapies in the pipeline—CMS may limit future access to treatments.”
The senators continued, “Although all in the same class, no two drugs work exactly the same for all individuals. Further, the evidence gathered from Aduhelm’s FDA confirmatory trial as well as additional evidence gathered by CMS may inform coverage decisions of potential future drugs. Each new medicine, in our view, should be reviewed on its own merits and not as a class.”
Noting that Black and Latino populations have higher incidences of Alzheimer’s, the senators also called on CMS to ensure that any clinical trial requirements do not inadvertently limit access to treatments for people of color.
“On behalf of people living with Alzheimer’s and their caregivers, thank you, Senators Warner, Markey and other Senate leaders, for sharing your concerns with CMS about the national coverage determination proposed decision and encouraging them to expand coverage of FDA-approved treatments for people living with Alzheimer’s. As it stands, the current draft would sharply limit access to an entire class of drugs. For the individuals living with this fatal disease, delaying and limiting access to treatment could mean further progression of their cognitive decline. We appreciate your continued leadership on issues important to the Alzheimer’s community,” said Robert Egge, Alzheimer’s Association chief public policy officer and Alzheimer’s Impact Movement (AIM) executive director.
“It is critically important to the Alzheimer’s community that CMS understand what many members of Congress already do: it’s wrong for Medicare to deny access to FDA-approved Alzheimer’s treatments. This would not happen with cancer, and it must not happen with Alzheimer’s,” said George Vradenburg, chair and co-founder of UsAgainstAlzheimer’s. “I applaud the senators for working on behalf of patients to increase access to this class of drugs, particularly among people of color. Every day 1,000 Americans slip from mild to moderate Alzheimer’s and out of the disease stage targeted by this class of drugs. We do not have time to wait. And we will not stop our campaign until this injustice is corrected.”
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Chris Graham
