Dive Brief:
- Medicare Part B premiums will remain the same this year even after Department of Health and Human Services Secretary Xavier Becerra called for a review following drugmaker Biogen's decision to cut the price of its Alzheimer's drug Aduhelm, which had led to this year's premium hike.
- Becerra had sought to cut premiums for seniors sooner rather than later but HHS said there are "legal and operational hurdles" to changing premiums mid-year, according to a statement released Friday.
- The expected reduction in Aduhelm costs will be rolled into premiums for next year, HHS said.
Dive Insight:
Last fall, health regulators braced for a potential spike in Medicare spending due to the Food and Drug Administration's approval of Biogen's pricey Alzheimer's drug. Amid the uncertainty and potential for higher outlays, officials raised Part B premiums.
However, the expected large increase in Medicare spending due to Aduhelm has not materialized as the drug is little used amid controversy over its approval and pushback from insurers over coverage.
Since Medicare premiums were announced last fall, Biogen cut Aduhelm's price in half and Medicare officials ultimately decided to sharply restrict access to the new drug. Medicare said it would not pay for the drug unless Medicare beneficiaries were enrolled in clinical trials.
Becerra had in January instructed health officials to reevaluate the increase to Medicare Part B premiums in response to Biogen's price cut, which brought Aduhelm's wholesale acquisition cost down to about $28,000 a year from $56,000 previously.
Becerra said Friday that premium reductions for seniors will have to wait until next year following the release of the report.
"We had hoped to achieve this sooner, but [the Center for Medicare and Medicaid Services] explains that the options to accomplish this would not be feasible," Becerra said in a statement.
Officials considered returning premiums to beneficiaries, but the internal report concluded CMS does not have the authority to send premium refunds to Medicare beneficiaries in this instance. Instead, the projected savings from Aduhelm will be applied to the 2023 premium.
The controversial new treatment for Alzheimer's disease was approved by the Food and Drug Administration last summer, a decision that generated scrutiny and pushback despite support from influential patient groups.