Though Strict, CMS Aduhelm Policy May Create Pressure For Wider Coverage

The proposed Medicare national coverage policy for Aduhelm, and other prospective monoclonal antibodies for Alzheimer’s, is stricter than most that have come before it. However, the national coverage determination might put some pressure on insurers that have refused to cover Aduhelm and the hospitals that aren’t prescribing it. CMS on Tuesday (Jan. 11) proposed a national coverage policy that includes so-called coverage with evidence development. The proposal calls for requiring a randomized controlled trial, or a trial sponsored by the...