Press Release

RELEASE — Statement on Medicare Proposal to Limit Aduhelm Coverage

Washington, D.C. (January 12, 2022) –In response to Medicare’s proposal to limit coverage of the controversial Alzheimer’s drug Aduhelm, ACHP President and CEO Ceci Connolly issued the following statement:

“ACHP is encouraged that the Centers for Medicare and Medicaid Services is taking concerns about the safety and efficacy of this unproven, expensive drug seriously. The FDA’s expert panel voted 10-0 against approval for a reason. Patients and families need a clearer understanding of whether this drug actually works, and we are encouraged that the federal health program has chosen to focus on gathering more data.

“Given the limited scope of the drug’s coverage within clinical trials, we hope this decision will factor into CMS’ reevaluation of Part B premium increases. Seniors should not have to pay almost 15 percent more each year for a controversially approved drug — one that many prestigious health systems have announced they will not cover. We look forward to ongoing conversations with CMS to reassure Americans that Medicare decisions are driven by the wellbeing of seniors and quality of care.”

For more on ACHP’s position on the controversial Alzheimer’s drug, read ACHP’s blog on “How Aduhelm’s Price Cut Misses the Mark” and our recommendations to CMS on Aduhelm coverage.

About ACHP

The Alliance of Community Health Plans (ACHP) represents the nation’s top-performing non-profit health plans to improve affordability and outcomes in the health care system. ACHP member companies are provider-aligned health organizations that provide high-quality coverage and care to tens of millions of Americans. They are leading the industry in practical, proven reforms around primary care delivery, value-based payment and data-driven systems improvement.

ACHP advocates on behalf of its members and a unique approach to health care today, one that puts the patient at the center with health plans and clinical teams collaborating to improve health outcomes and reduce costs. Our advocacy focuses on providing policymakers with tested solutions being realized in communities nationwide and rooted in a model that is proven to deliver better value for patients, employers and taxpayers. Learn more at the ACHP website and follow us on Twitter for the latest health insights.