Blues plans go on together with aducanumab on formulary
A number of Blues plans have determined they won’t cowl Biogen’s controversial Alzheimer’s illness drug Aduhelm because the business weighs the professionals and cons of what’s set to be a pricey however in-demand remedy.
New York-based Excellus BlueCross BlueShield introduced late final week that it’ll not cowl the therapy on account of issues over its efficacy, Syracuse.com reported.
The drug “has not been medically confirmed to be efficient and, due to this fact, is taken into account investigational for the therapy of Alzheimer’s illness,” the insurer stated in an announcement.
Six different Blues insurers have additionally determined they won’t cowl Aduhelm in any respect. Others, resembling Highmark, stated they’ll cowl it solely with prior authorization.
RELATED: Trade Voices—For payers, figuring out Aduhelm protection is a ready sport
Some massive suppliers have reportedly additionally declined to cowl the remedy, together with Cleveland Clinic and Mount Sinai.
As extra payers and suppliers contemplate subsequent steps associated to Aduhelm—and the business awaits the Facilities for Medicare & Medicaid Providers’ nationwide protection dedication—here is a roundup of key protection choices on Aduhelm from throughout healthcare.
Division of Veterans Affairs will not embody Aduhelm on formulary
The Division of Veterans Affairs (VA) is not going to embody aducanumab on its formulary, the company introduced, on account of a “danger of serious opposed drug occasions” and a scarcity of proof on its scientific efficacy.
Gross sales representatives will even not have the ability to promote the drug to VA docs, in accordance with inner paperwork.
The company additionally launched a listing of necessities earlier than a VA affected person will be prescribed Aduhelm.
Extra from Fierce Pharma.
