June 18, 2024 8:19 pm
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Opinion | Medicare Patients Deserve Access to New Alzheimer’s Treatments

Credit: iStock

By Marla Hickman

The devastating impacts of Alzheimer’s disease are hard to put into words for those who have not witnessed them firsthand. This disease robs people of their memories, their mind and forces families to watch their loved ones fade away. Thankfully, scientific progress has led to advancements in treating the progression of this disease. However, access to these drugs is, unfortunately, a challenge.

For many decades, no drugs addressed the root causes of the disease, only therapies to help mitigate symptoms. However, a new class of Alzheimer’s drugs has been approved by the Food and Drug Administration (FDA). These disease modifying therapies use monoclonal antibodies (mAbs) directed against amyloid for the treatment of Alzheimer’s disease. These drugs are a huge step forward in our treatment of Alzheimer’s as they have been shown to help to slow or even stop the progression of the disease. One would think this new category of medications approved for Alzheimer’s disease would be something the Centers for Medicare and Medicaid Services (CMS) would approve coverage for quickly. However, CMS took the unprecedented step of limiting coverage of these Alzheimer’s drugs. Typically if the FDA approves a drug, Medicare pays for it. But CMS said it wasn’t convinced that this new class of Alzheimer’s drugs is reasonable and necessary for seniors. Medicare said it would only pay for these treatments if patients enroll in randomized controlled trials. This means that only patients who live near medical centers who conduct these types of trials would have access to this life changing medication, and that is unconscionable.

There is no reason that an FDA approved drug that has been shown to be safe and effective should then be made virtually inaccessible for the vast majority of people who need it most. If a patient, their family and their doctor agree this treatment is right for them, it should be covered by CMS- no questions asked. In March of this year the Veterans Health Administration announced that they would cover these medications for veterans with early stage Alzheimer’s because the clinical evidence and research shows that there are many people who will see benefits from these types of therapies. CMS should take a page out of the VA’s book and provide that same coverage for other seniors. 

This new class of Alzheimer’s drugs have been shown to slow cognitive decline and help people continue to do what they love for a longer amount of time than with no treatment. CMS’ role is to provide health care coverage- not to stand in the way of patients getting the care they need. They must reverse their decision and cover these life changing medicines. Senator Rosen has been a champion for Nevada families and she can continue that great work by encouraging CMS to reverse their decision. There is no time to waste.