Make or break for Biogen: How the national coverage decision for amyloid-targeted Alzheimer’s drugs will shake out
Ever since Biogen’s controversial Alzheimer’s drug Aduhelm won an accelerated approval in June, despite scant evidence of clinical benefit, the country has turned its attention to who might use the drug and who would pay for it.
So far, not too many have done either, with Biogen hauling in just $300,000 in early sales, and insurers still waiting to see what CMS will do with its national coverage decision, or NCD. The NCD will serve as the basis for how insurers decide to cover Aduhelm. The decision will provide CMS’ thinking behind whether Aduhelm and other potential amyloid-targeted drugs either are or are not “reasonable and necessary” for the treatment of Alzheimer’s disease.
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