Medicare rejects Alzheimer's Association request for unrestricted coverage of treatments like Leqembi
Publishing timestamp: 2023-02-23 12:33:51
Summary
The Centers for Medicare and Medicaid Services (CMS) rejected a request from the Alzheimer's Association for unrestricted coverage of antibody treatments that target brain plaque. CMS said it needs to see more evidence demonstrating that treatments such as Eisai's Leqembi are reasonable and necessary. The Alzheimer's Association is "appalled" by CMS' decision and members of Congress have called on CMS to change its policy and offer broader coverage of Alzheimer's antibody treatments. Eisai expects to receive full FDA approval this summer, but even with full approval, Medicare's policy is to cover Alzheimer's treatments for patients who agree to participate in research studies that collect real-world data.
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