WASHINGTON — The Food and Drug Administration last month foisted a nearly impossible decision on insurers: Should they pay for an expensive new Alzheimer’s drug that may not actually help patients?
Normally, if a drug gets FDA approval, that means it has some benefit to patients. But the FDA decided to greenlight Biogen’s controversial drug Aduhelm without that guarantee.
That decision leaves patients, clinicians, and insurance companies in the dark. Under by far the most pressure is Medicare, since most patients eligible for the pricey drug have insurance through the taxpayer-funded program. Officials with the program just this week started the process for figuring out how Medicare will cover the drug, which will take months.
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