An un­ortho­dox pro­pos­al for Bio­gen's Medicare-man­dat­ed Aduhelm tri­al

Bio­gen has gone full blitz since Medicare an­nounced it would on­ly cov­er its new Alzheimer’s drug when used in clin­i­cal tri­als, ac­cus­ing the agency of dis­crim­i­nat­ing against Alzheimer’s pa­tients and try­ing to get physi­cians to change reg­u­la­tors’ minds. Crit­ics, mean­while, cheered what they see as a nec­es­sary wall pro­tect­ing pay­ers and pa­tients from an un­proven and un­safe drug.

Far less at­ten­tion, though, has gone to what a Medicare-fund­ed clin­i­cal tri­al would ac­tu­al­ly look like. Bio­gen has op­er­at­ed as if it would be a stan­dard late-stage Alzheimer’s tri­al, en­rolling a cou­ple thou­sand pa­tients and giv­ing half place­bo.

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