WASHINGTON — Oregon is gearing up to ask the Biden administration if its Medicaid program can avoid paying for drugs approved through a fast-track approval pathway — like Biogen’s pricey, controversial new Alzheimer’s drug, Aduhelm.
Oregon announced this month it is planning to formally submit a request to the administration to let its state out of a law that requires Medicaid programs to cover nearly all Food and Drug Administration-approved drugs.
The state is asking to create a so-called closed formulary, where Medicaid would only have to cover one drug for each therapeutic class, like antivirals or antidepressants. It also wants the power to conduct its “own rigorous review process to determine coverage of new drugs,” and to not cover drugs “with limited or inadequate evidence of clinical efficacy.” The request explicitly mentions the FDA’s accelerated approval pathway, which lets the FDA approve drugs without clear evidence they help patients live longer or cure their disease. (The request does not mention any specific drugs by name, including Aduhelm.)
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