Alzheimer’s Drug Cited as Medicare Premium Jumps by $21.60 – NBC 5 Dallas-Fort Worth

Medicare Part B Outpatient Premium will increase by $ 21.60 per month in 2022, one of the largest increases of all time. Officials said Friday a new Alzheimer’s drug is responsible for about half of that.

The hike guarantees that healthcare will devour a large chunk of the recently announced Social Security Living Allowance, a hike that had slumped to $ 92 per month for the average retiree to cover the rising prices of gasoline and groceries Seniors pinch.

Medicare officials told reporters Friday that about half of the increase is due to contingency planning if the program ultimately has to cover Aduhelm, the $ 56,000-a-year drug for Alzheimer’s disease from drug company Biogen. The drug would add to the cost of outpatient care as it is given intravenously in a doctor’s office and paid for under Part B.

The subject evolves into a case study of how an expensive drug for a disease that affects millions of people can drive government spending up and affect household budgets. People who do not have Alzheimer’s would not be shielded from the cost of Aduhelm because it is large enough to affect their premiums.

The new Part-B premium will be $ 170.10 per month for 2022, officials said. The jump from $ 21.60 is the biggest increase ever in dollars, if not a percentage. As recently as August, the Medicare Trustees report had forecast a smaller increase of $ 10 from the current $ 148.50.

“The increase in the Part B premium for 2022 is further evidence that rising drug costs threaten the affordability and sustainability of the Medicare program,” said Chiquita Brooks-LaSure, chief executive officer of Medicare, in a statement. Officials said the other half of the premium increase is due to the program’s natural growth and adjustments that Congress made last year due to the coronavirus pandemic.

The announcement late Friday afternoon – in a window of time when government agencies are posting bad news – comes as Congress is considering considering a Democratic bill, backed by President Joe Biden, that would restrict Medicare payments on drugs. However, under the latest compromise, Medicare would not be able to negotiate prices for newly introduced drugs. The news of Medicare rewards could reopen that debate internally among Democrats.

“Today’s announcement … reaffirms the need for Congress to finally give Medicare the ability to negotiate lower prices for prescription drugs,” Frank Pallone, DN.J., Rep. Frank Pallone, DN.J., said in a statement. “We just can’t wait any longer to really take the strain off seniors.” Pallone was a proponent of the original House version of the legislation, which took a tougher approach to the pharmaceutical industry.

Alzheimer’s is a progressive neurological disease with no known cure that affects approximately 6 million Americans, the vast majority of whom are old enough to qualify for Medicare.

Aduhelm is the first Alzheimer’s drug in almost 20 years. It doesn’t cure the life-destroying condition, but the Food and Drug Administration noted that its ability to reduce plaque clumps in the brain is likely to slow down dementia. However, many experts say the benefits have not been clearly demonstrated.

Medicare has started a formal evaluation to see if the drug should be covered and a final decision is unlikely to be expected until spring. Medicare is currently deciding on a case-by-case basis whether Aduhelm will be paid.

Traditionally, costs are not included in Medicare coverage. But even in this case there is a lot of discussion about the effectiveness of Aduhelm. Last November, an FDA advisory panel voted almost unanimously against recommending its approval, citing flaws in company studies. Several members of the panel resigned after the FDA nonetheless approved the drug because of their objections.

A month after a controversial new Alzheimer’s drug was approved, the FDA signed new prescribing instructions to restrict its use to patients with early or mild cases of the disease. The acting head of the FDA, Dr. Janet Woodcock also announced that she is ordering an investigation into whether the agency acted inappropriately in approving the drug.

A nonprofit think tank focused on drug pricing estimated Adulhelm’s real worth at between $ 3,000 and $ 8,400 a year – rather than $ 56,000 – based on its unproven benefits.

But Biogen has defended its pricing, saying it has carefully considered the cost of advanced drugs used to treat cancer and other diseases. The company also expects the Alzheimer’s drug to be rolled out gradually, rather than a “hockey stick” scenario where costs will rise. Still, Medicare officials told reporters they need to plan for contingencies.

Two House Committees are investigating Aduhelm’s development, including contacts between corporate executives and FDA regulators.

Medicare covers more than 60 million people, including those aged 65 and over, as well as people with disabilities or severe kidney disease. Program spending is approaching $ 1 trillion a year.

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