Activists call for adding new Alzheimer’s drug to Medicare coverage

Protesters in Washington on Tuesday urged federal officials to reverse course and expand Medicare coverage for the first new FDA-approved treatment for Alzheimer’s in nearly two decades.

Around 100 activists rallied outside Health and Human Services offices to voice opposition to January’s preliminary decision from the Centers for Medicare & Medicaid Services (CMS) that limits Medicare coverage for a new Biogen drug that targets amyloid-beta plaques in the brain.

That ruling, expected to be finalized April 11, limits Medicare coverage to beneficiaries who participate in upcoming clinical trials.

“It’s the people who are living with Alzheimer’s disease, informed by their doctors, that should have the option to use FDA-approved drugs,” said Sue Peschin, president of the Alliance for Aging Research, a District of Columbia-based nonprofit. “Medicare should not take that option away.”

Jim Taylor, whose wife Geri suffers from Alzheimer’s, appeared with her at the rally.

“Yes, it works, but no, you can’t have it,” Mr. Taylor said, referring to the CMS decision.

Terrie Montgomery, diagnosed with early-onset Alzheimer’s, said she would be an ideal candidate for the new treatment.

“Why would we deny anyone to be treated for it?” Ms. Montgomery asked.

The FDA approved the drug Aduhelm (aducanumab) from Massachusetts-based Biogen and Japan’s Eisai Company, in June.

Both the FDA and CMS are part of the Department of Health and Human Services.

In a statement emailed Tuesday to The Washington Times, CMS said it is “currently reviewing comments received” as it prepares to make a final decision next month.

“CMS values feedback from stakeholders, and looks forward to reviewing all comments received on the proposed determination,” the statement reads.

But it’s unlikely that CMS, which administers Medicare, will reverse the ruling.

Dr. Lee Fleisher, CMS chief medical officer and director of the Center for Clinical Standards and Quality, said in a press release Jan. 11 that it was necessary to limit Medicare coverage of the new drug to clinical trials due to “robust evidence” showing potentially harmful side effects.

“This harm may range from headaches, dizziness, and falls, to other potentially serious complications such as brain bleeds,” Dr. Fleisher said.

According to the most recent data from the Centers for Disease Control and Prevention, 134,242 Americans died of Alzheimer’s dementia in 2020, making it the seventh leading cause of death in the United States that year.

The CDC reports as many as 5.8 million Americans were living in 2020 with the gradual memory-loss disease, which primarily impacts people older than 65.

Correction: An earlier version of this article citing incorrect information from the Department of Health and Human Services misreported the date that January’s preliminary ruling is expected to be finalized. A decision is expected April 11.