Although the FDA has determined lecanemab's benefits outweigh its risks in treating Alzheimer's, the CMS is pressing for more data on its efficacy and safety.
Some Medicare patients are being denied access to a key Alzheimer's drug.Alzheimer's is an incurable disease that affects roughly 6.7 million Americans. In recent years, research has unveiled two treatments, lecanemab and donanemab, Joe Grogan, a health care consultant and senior fellow at the University of Southern California's Schaeffer Center for Health Policy & Economics, wrote in a Chicago Tribune op-ed piece.
For instance, Grogan said PET scans are the 'gold standard' for Alzheimer's diagnosis but CMS didn't offer PET scans or an additional test cover for many years.'After tying up these tests in CED for more than a decade, CMS finally concluded last October what we've known for years: that the preponderance of data supports using PET scans to diagnose Alzheimer's disease,' Grogan wrote. 'Now we must ensure equitable access to these tools in practice.
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