Last week, Medicare announced an unusually strict decision about treatment of a Biogen Alzheimer’s drug, Aduhelm. Medicare, which is the U.S. health plan for people 65 years old and over, said that it will not cover the price of Aduhelm except when the patients taking it are part of clinical trials. This puts Medicare sharply at odds with the Food and Drug Administration, which approved Aduhelm’s use in June 2021.
The FDA found last year that Aduhelm clears amyloid plaque from the brain and that this will likely help slow cognitive decline for Alzheimer’s patients. Amyloid plagues are misfolded protein molecules that build up in the spaces between nerve cells. The precise mechanism by which they wreak their havoc is unclear. But where the build-up occurs, neurons die. This of course explains why treatment-oriented research has focused on the issue of clearing these plaques.
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Around 85% of the people who might use Aduhelm are covered by Medicare, so the decision mean Biogen will drop Aduhelm altogether. The decision came about over a concern with risks. At least one patient, a 75-year-old woman who was part of a clinical trial, has died after taking the drug and experiencing brain swelling.