VA's Aduhelm Restrictions: Big Symbolism But Small Impact?
Biogen is ‘pleased’ access will be available through exceptions process in formulary restrictions though the US veterans agency does not expect there will be ‘significant’ interest among its clinicians in prescribing through that process. Price was not deciding factor, agency says.
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Proposed reimbursement decision to be released by 12 January 2022, with a final decision the following April. Biogen's Aduhelm expected to be covered in the interim. Medicare will not consider the cost of treatment in the analysis, but cost may have been a factor in initiating the process.
Pink Sheet reporter and editors discuss the CMS coverage decision for Biogen and Eisai’s Alzheimer’s treatment Aduhelm, the FDA conducting fewer advisory committee meetings in 2021 and the Defense Department’s efforts to increase domestic drug production.
Biogen exec suggests subcutaneous injectable forms of Alzheimer’s treatments subject to Medicare’s draft national coverage determination might find better patient access if they are covered by the Part D program, but that path comes with its own set of risks.