Part B premiums may be reduced by Medicare

Part B premiums may be reduced by Medicare

After the price of a contentious new drug was dropped, seniors may notice a reduction in their monthly Medicare Part B costs in 2022.

Medicare set the monthly Part B premium for this year at $170.10, an increase of more than 14% from 2021. The surge, according to the agency, is due in part to Medicare beneficiaries being administered Aduhelm, a Biogen Alzheimer’s medication that was authorized by the Food and Drug Administration last year. Part B covers the medicine because it must be delivered by a physician. The medicine was originally set to cost $56,000 per patient per year, however Biogen later stated that the price will be decreased to $28,200.

In a press release on Monday, Health and Human Services Secretary Xavier Becerra said he has urged Medicare to “reevaluate the proposal for the 2022 Medicare Part B premium, given the substantial price change of the Alzheimer’s Drug, Aduhelm.”

“There is a compelling justification for CMS to revisit the earlier advice,” he added, citing Aduhelm’s 50% price cut on January 1.

Before the drug’s price was dropped in June, the Kaiser Family Foundation calculated that if a quarter of the 2 million Medicare beneficiaries prescribed an Alzheimer’s therapy under Part D in 2017 used Aduhelm, it would cost Medicare $29 billion in a year. According to KFF, Medicare paid $37 billion on all Part B medications in 2019.

Experts have raised concerns about Aduhelm’s effectiveness and potential adverse effects, prompting Medicare to conduct a national coverage decision to determine whether or not to pay for the medication. The agency proposed on Tuesday that it would only pay treatment for specific patients in clinical trials. Furthermore, Medicare would only pay people with mild cognitive impairment or dementia who have the protein in their brain that Aduhelm is designed to target.

The proposal’s restrictions are likely to limit the number of Medicare enrollees who can get the medicine. The idea is expected to be approved later this year, with some changes possible.