Sanders demands refunds for seniors hit by Medicare premium hike

The Vermont senator's call came after federal officials said Medicare should limit coverage of an unproven and expensive Alzheimer's drug.

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SOURCECommon Dreams

Sen. Bernie Sanders on Tuesday demanded refunds for seniors who have been hit by the 2022 Medicare premium hike after federal health officials recommended limiting the program’s coverage of Aduhelm, the unproven and expensive Alzheimer’s drug responsible for a large chunk of the premium increase.

In a statement, Sanders said CMS officials’ preliminary decision Tuesday to restrict coverage of Biogen’s Aduhelm to patients taking part in approved clinical trials was “an important step forward.” CMS’ final decision on the drug is expected by April.

“I urge the administration to immediately lower Medicare premiums by at least $11.50 a month and to provide a refund to 57 million senior citizens for the premium increases that have already gone into effect this month,” Sanders continued. “I would also urge the president to reinstate and expand the reasonable pricing clause that requires drug makers who have benefited from taxpayer-funded research to charge reasonable prices for drugs and treatments.”

“Americans should not have to pay an outrageous price for a drug that their tax dollars helped develop,” he added.

CMS’ announcement Tuesday came just 24 hours after Health and Human Services Secretary Xavier Becerra instructed federal officials to “reassess” the increase in monthly Medicare Part B premiums to $170.10 in 2022, up from the previous year’s level of $148.50—one of the largest premium hikes in the program’s history.

Becerra did not provide a specific timeline for action.

The Washington Post‘s Amy Goldstein noted Monday that “beginning with this month’s checks, which start to be issued this week, Social Security has a 5.9% cost-of-living increase for 2022, but many people on Medicare may first notice that the relatively large premium increase for their health insurance is cutting into the size of their checks.”

CMS has attributed roughly half of the 2022 Medicare premium increase to “additional contingency reserves” needed for the program’s potential coverage of Aduhelm, which the Food and Drug Administration approved in June despite experts’ vocal warnings that the drug had not been shown to be effective at slowing Alzheimer’s-induced cognitive decline.

In his statement Tuesday, Sanders pointed to the fact that Aduhelm—now priced at $28,000 annually—”was rejected for coverage by the Veterans Health Administration and at least a half a dozen private health insurance companies in the United States, while 10 out of the 11 experts on the Food and Drug Administration’s advisory council voted against approval of the treatment.”

“Biogen’s outrageous original price for Aduhelm, $56,000 per year, is the poster child for how dysfunctional our drug pricing system has become and it is the perfect example of why Medicare should be negotiating drug prices with the pharmaceutical industry,” said Sanders. “If the administration takes no action, Medicare recipients will continue to see their biggest premium increase in history, all because of Biogen’s greed. That cannot be allowed to happen.”

Dr. Michael Carome, director of Public Citizen’s Health Research Group, also applauded CMS for proposing to limit Medicare’s coverage of Aduhelm, the accelerated approval of which led several FDA advisers to resign in protest.

“Implementation of this proposed decision would significantly mitigate the damage done by the Food and Drug Administration’s reckless decision last year to approve [Aduhelm] despite the lack of scientific evidence that the drug provides any clinically meaningful benefit to Alzheimer’s patients with respect to cognitive function outcomes and clear evidence that it can cause serious brain injury,” said Carome.

“Unlike the FDA,” he added, “CMS wisely chose to follow the scientific evidence.”

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