WASHINGTON — Biogen and other drugmakers have already hinted they might sue Medicare over its decision to limit coverage for the controversial new drug, Aduhelm — a legal challenge that could have massive implications for patients and pharmaceutical companies that extend far beyond those focused on Alzheimer’s disease.
Even before Medicare officials made their limits on the drug official last week, Biogen had said it didn’t believe such restrictions would hold up in court. Other drugmakers potentially impacted by the decision, like pharmaceutical giant Eli Lilly, raised similar objections.
Neither drugmaker has definitively said that it will sue Medicare, but a number of experts — including the official who helped create the “coverage with evidence development” pathway that Medicare used to restrict its coverage — acknowledge that drugmakers have a shot at challenging the decision.
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