May 5, 2023

Bipartisan AGs Advocate for Unrestricted Access to Alzheimer’s Disease Treatment for Medicare, Medicaid Patients

Cozen O'Connor

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Cozen O'Connor

A bipartisan coalition of 26 AGs, led by Oklahoma AG Drummond and Minnesota AG Ellison, wrote a letter to the Centers for Medicare & Medicaid Services (CMS) and HHS urging them to provide full, unrestricted coverage of an FDA-approved treatment to delay the progression of Alzheimer’s Disease.
In the letter, the AGs note that lecanemab, a monoclonal antibody (mAb), received FDA approval for treatment of Alzheimer’s Disease in January 2023 following positive results in a phase 3 trial. However, lecanemab will not be covered for all Medicare and Medicaid patients due to a prior CMS national coverage determination (NCD) that mAbs would only be covered when they are administered through clinical trials or other studies. The AGs argue that the NCD creates physical and financial burdens on patients to travel to research institutions hosting trials, and creates a barrier to care for individuals living in rural and underserved areas.
The AGs ask CMS to reconsider its coverage decisions for FDA-approved mAbs for the treatment of Alzheimer’s Disease, including lecanemab.

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