26 attorneys general from both political parties urged Medicare to change its contentious policy that restricts coverage to participants in clinical trials and to cover antibody-based Alzheimer’s medications like Eisai and Biogen’s Leqembi without limitations.
The request for full and unrestricted coverage of FDA-approved monoclonal antibodies directed against amyloid for the treatment of Alzheimer’s was made in a letter to CMS by Minnesota’s Keith Ellison and Oklahoma Attorney General Gentner Drummond.
Medicare’s Coverage Decision
Leqembi infusions given twice a month have demonstrated potential in reducing the progression of early Alzheimer’s to more advanced stages of the mind-robbing illness.
Due to Medicare’s decision to limit coverage, only wealthy seniors can afford to pay an out-of-pocket maximum of $26,500 annually.
Attorneys general noted that Leqembi has some side effects, including hemorrhage and brain swelling, but they suggested that families and their doctors weigh these risks against the advantage of patients being able to identify their loved ones for a longer period of time.
One of the few causes on which both sides of the political spectrum can agree in a country with severe political rifts is the drive to make Alzheimer’s therapies widely accessible.
In February, more than 70 House members and 18 senators urged Medicare to cover Alzheimer’s treatments without limitations.
Leqembi’s coverage by Medicare will be expanded if it wins complete FDA approval on July 6.
Read more: Government Caves To Insurance Industry Pressure On Medicare Advantage
Purpose of Medicare in Alzheimer’s Treatment
However, patients in the senior program will still be required to take part in fictitious registries that compile information about the course of treatment.
Last week, Brooks-LaSure made a commitment to Congress that these registries would not obstruct access to treatment.
Attorneys general from the following states and the District of Columbia signed the letter: Arizona, Arkansas, Connecticut, Delaware, Florida, Idaho, Indiana, Maine, Michigan, New Hampshire, New Jersey, New Mexico, North Dakota, Northern Mariana Islands, Minnesota, Ohio, Oklahoma, Oregon, Pennsylvania, Puerto Rico, South Carolina, Texas, Utah, Vermont, Virginia, and West Virginia.
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