Medicare administrators have finalized plans to broaden coverage of PET scans for Alzheimer's patients.
Medicare administrators have finalized plans to broaden coverage of PET scans for Alzheimer's patients — a move that potentially boosts the fortunes of promising new antibody treatments likeThat could allow providers to make more diagnoses and determine whether treatment with the new drugs is appropriate.
Leqembi was found to slow progression of the disease and reduce the buildup of sticky beta-amyloid plaques in the brains of patients.CMS will leave it to Medicare contractors to make the actual coverage decisions, which could cause confusion and may force the agency to revisit its decision, Cowen analyst Eric Assaraf wrote in a note.
CMS agreed to pay for the drug for Medicare beneficiaries if health providers agree to collect and share data about the drug's performance. The agency had previously restricted coverage to those patients enrolled in clinical trials., which was shown to be 35% effective at slowing the rate of the disease, and 60% effective in early-stage patients.
The nonprofit organization, which assesses the value of drugs, suggested that Leqembi should cost between $8,900 and $21,500. More than 6 million people are living with Alzheimer's in the U.S., and the number is expected to more than double by 2050, per the Alzheimer's Association.Share on linkedin
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