CMS Cost Estimate is Outdated by $6 Billion Based on Reduced Price and Updated Projected Usage of Aduhelm

Washington, D.C. (December 22, 2021) -- UsAgainstAlzheimer’s, a patient advocacy group representing more than six million Alzheimer’s patients and their families, sent a letter today to Secretary Xavier Becerra calling on the administration to reverse the historic premium increase for Medicare Part B announced last month.

The full text of the letter is below:

The Honorable Xavier Becerra

Secretary

Department of Health and Human Services

200 Independence Avenue, S.W.

Washington, DC 20201

 

Dear Secretary Becerra,

Yesterday, Biogen, the manufacturer of Aduhelm, made an announcement that could be life-changing for millions of Americans living with Alzheimer’s disease. By committing to cut the drug’s price in half, Biogen is potentially increasing patient access to the only treatment available that modifies the course of Alzheimer’s. We call on the Department of Health and Human Services (HHS) to take similar action benefitting patients by having the Centers for Medicare and Medicaid Services (CMS) make two pro-patient determinations for this class of disease-modifying Alzheimer’s drugs.

Last month, CMS announced a 14.5% increase, the largest in history, in Medicare Part B premiums and pointed squarely at Alzheimer’s patients and this treatment as one of the primary causes of that increase. Whatever the merit of that decision at the time, with Monday’s news from Biogen regarding both price and projected utilization of the therapy, CMS’ calculations are now outdated to the potential detriment of all Part B beneficiaries.

While CMS stated that the increase was needed to boost “additional contingency reserves due to the uncertainty regarding the potential use” of Aduhelm, Biogen told the public markets Monday that it expects approximately 50,000 patients to initiate Aduhelm treatments in 2022. That estimate is significantly lower than the assumption used by CMS when it made the decision to increase Medicare premiums.

With this information, on behalf of America’s six million Alzheimer’s patients and their families, UsAgainstAlzheimer’s calls on the administration to: (1) reverse the historic Part B premium increase announced last month, and (2) to make a National Coverage Decision (NCD) that makes this treatment available to every patient for whom it is appropriate and who chooses to use it.

 

Respectfully,

George Vradenburg

UsAgainstAlzheimer’s Chair and Co-founder

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About UsAgainstAlzheimer’s

UsAgainstAlzheimer’s exists to conquer Alzheimer’s disease. We take on the toughest problems; bring all of “Us” together to break down barriers; advocate for research that will speed treatments to market; and drive changes that matter most to people living with the disease. We will not rest until brain-span equals lifespan - for everyone.