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WASHINGTON — Biogen is calling Medicare’s bluff.

The federal health insurance program for people 65 and older proposed to drastically limit how often it would pay for the embattled biotech’s controversial Alzheimer’s drug, Aduhelm, a blow to Biogen’s hopes for wide uptake among Medicare patients. Medicare said it needed more information about the drug’s efficacy and safety and said it would only pay for the drug for patients enrolled in clinical trials.

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Now, Biogen has a new proposal: The company will get Medicare the extra data it wants, but not through the slow, traditional trials Medicare is proposing. Instead, it will focus on speedier real-world evidence about the drug. Biogen can’t get that wider dataset, the company says, if the drug is only available for such a limited patient population.

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