People with Medicare are paying about $11 a month in extra Part B premiums this year but, next year, everyone with Medicare should see lower Part B premiums according to HealthCareFinanceNews. After factoring the cost of covering Aduhelm, a new exceedingly costly Alzheimer’s drug, into this year’s Part B premium, the Biden administration determined that Medicare would not cover the drug, except in limited circumstances. Still it is not giving people a refund or adjusting the Part B premium until next year.
Medicare’s projected spending on Aduhelm is responsible for $11 in Part B premiums this year based on the manufacturer’s $56,000 a year launch price and an assumption that Medicare would cover it. Since the Part B premium was calculated, however, Biogen, the manufacturer cut the launch price in half, and Medicare said it would only cover the drug for people in clinical trials.
The Biden Administration claims it cannot lower the Part B premium this year because of administrative and legal obstacles. Secretary of Health and Human Services, Xavier Becerra said that “After receiving CMS’s report reevaluating the 2022 Medicare Part B premiums, we have determined that we can put cost-savings directly back into the pockets of people enrolled in Medicare in 2023.” “We had hoped to achieve this sooner, but CMS explains that the options to accomplish this would not be feasible.”
Fierce Healthcare reports that a CMS report goes further: CMS “does not have sufficient authority to send premium refunds directly to beneficiaries unless there is excess payment relative to the established premium.” If CMS had not considered the cost of Aduhelm in its Part B premium calculation this year, the premium would have been $160.40.
Because the Centers for Medicare and Medicaid Services factored the cost of Aduhelm into the Part B premium, the 2022 Part B premium is $21.60 higher than it was last year, a 14.5 percent increase.
Aduhelm has been found to have serious and sometimes even deadly side effects and no clear benefits. The manufacturers of Aduhelm ended two clinical trials because the drug was not helping people. At any price, the drug is likely ill-advised based on the clinical evidence to date. At $27,000, it’s insane.
Here’s more from Just Care:
- Medicare won’t cover Alzheimer’s drug, except in clinical trials
- New Alzheimer’s drug drives up Part B premiums
- New Alzheimer’s drug has questionable benefits and costs a small fortune
- Should you be tested for Alzheimer’s?
- What are Medicare premium and other costs in 2022?
I don’t understand why part B was raised to cover a drug when Paet B does not cover drugs? Please I really want to know.
Because Medicare has a Part D prescriptiom drug benefit, many people do not realize that Part B also covers prescription drugs. The difference is that Part D covers drugs you get at the pharmacy and self-administer. Part B covers drugs administered by a health care provider, generally in a hospital or doctor’s office.