Sanders demands end to Medicare premium hike from Alzheimer’s drug

Biogen's original price for the controversial drug, he argues, "is the perfect example of why Medicare should be negotiating drug prices with the pharmaceutical industry."

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SOURCECommon Dreams

Building on his recent letter to U.S. President Joe Biden, Sen. Bernie Sanders on Tuesday wrote to a key government analyst to push for a swiftly ending a Medicare premium hike tied to Biogen’s pricey and potentially ineffective Alzheimer’s drug.

“The Centers for Medicare and Medicaid Services (CMS) made the correct decision to sharply limit Medicare coverage for the Alzheimer’s drug Aduhelm to qualified clinical trials,” Sanders (I-Vt.) wrote to David Dolan, lead analyst for the federal agency.

While CMS issued the preliminary decision limiting coverage of the drug earlier this month—which Sanders previously welcomed as “an important step forward”—the agency isn’t expected to make a final decision for a few more months.

“I would strongly urge that this proposal be finalized as soon as possible,” Sanders’ letter says, “and that CMS reject calls by the pharmaceutical industry to greatly expand coverage for this vastly overpriced and controversial drug.”

The agency’s initial decision came just a day after Health and Human Services Secretary Xavier Becerra ordered federal officials to “reassess” hiking monthly Medicare Part B premiums to $170.10—up from $148.50 in 2021—about half of which was blamed on uncertainty about covering the drug, also known as aducanumab.

“While I applaud Secretary Becerra’s decision to instruct CMS to reconsider the outrageous increase in Medicare premiums attributable to the original $56,000 price tag for Aduhelm,” Sanders wrote, “much more must be done.”

Echoing earlier remarks, Sanders told Dolan that the Biden administration “should immediately lower Medicare premiums by at least $11.50 a month and provide a refund to some 57 million senior citizens for the premium increases that have already gone into effect this month.”

Biogen slashed Aduhelm’s annual price per person to $28,200 in late December—on the same day a group of scientists argued it was “indefensible” for the Food and Drug Administration (FDA) to approve the drug, which they said should be “withdrawn from the market immediately.”

Sanders pointed out that “the Institute for Clinical and Economic Review, an independent nonprofit organization, has estimated that, even if it were proven to be effective, the maximum price of Aduhelm should be no higher than between $3,000 and $8,400.”

The senator’s letter adds:

If the administration accepts Biogen’s price for this drug, seniors who receive it would be forced to come up with a 20% co-pay of $5,600 out of their own pockets—which would be simply unacceptable.

In my view, the administration must reinstate and expand the reasonable pricing clause that was established in 1989 by the National Institutes of Health requiring drug makers to charge “reasonable” prices for prescription drugs and treatments that receive federal funding—a policy that was revoked in 1995.

Biogen’s original price for the questionable drug, he argued, “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.”

While drug pricing reforms were included in the House-approved Build Back Better Act that is backed by Biden, the sweeping package has stalled in the Senate—where it needs full Democratic support to pass—due to opposition from Sens. Joe Manchin (D-W.Va.) and Kyrsten Sinema (D-Ariz.).

Along with detailing premium and drug price concerns, Sanders’ letter highlights that Aduhelm has been rejected by the U.S. Department of Veterans Affairs (VA), the European Medicines Agency, major private health insurers and hospitals, and all but one member of the FDA’s scientific advisory panel—three of whom resigned in protest over the drug’s approval.

Sanders asserted that “at a time when 10 out of 11 experts on the FDA’s advisory committee voted against approving Aduhelm, when the VA announced that it would not be covering Aduhelm due to safety concerns, and when the European Union and at least a half a dozen private health insurance companies have also decided not to cover Aduhelm, neither should Medicare.”

“Alzheimer’s is a horrible disease and we must do everything possible to find a cure for the millions of seniors who suffer from it,” he wrote, “but we cannot allow pharmaceutical companies to rip off seniors.”

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