JustCare

Tag: Alzheimer’s

  • Who should take Leqembi, an Alzheimer’s drug?

    Who should take Leqembi, an Alzheimer’s drug?

    After years of review, the FDA approved Leqembi—lecanemab–for the treatment of Alzheimer’s. So, now, Medicare covers this drug. But, it’s not clear if any of the 6.5 million Americans with Alzheimer’s should take the drug, given that it can cause brain swelling and bleeding. Laurie McGinley reports for the Washington Post on the pros and cons of Leqembi.

    The clinical data indicate that, in some cases of individuals with early-stage dementia and a build-up of amyloid in their brains, Leqembi can slow cognitive decline for five months or so. But, Leqembi cannot stop the progression of Alzheimer’s disease, and it appears that it might not always be safe or effective.

    Medicare covers Leqembi under Medicare Part B for people with amyloid buildup in their brains. Patients who want the drug might have to pay out of pocket for a PET scan to demonstrate that building or get a spinal tap. They or their supplemental insurer is also responsible for the 20 percent coinsurance, more than $5,000.

    Medicare is requiring anyone administering the drug, which is injectable, to participate in a registry that documents Leqembi’s efficacy in the real world. And, people who take it will see a warning label that underscores the drug’s dangerous side effects, including brain bleeding and swelling.

    People on blood thinners are at extra risk of brain bleeds if they take Leqembi. So, the FDA has warned physicians to consider carefully whether to prescribe the drug to these people.

    To be clear, Leqembi does not improve memory or cognitive skills. It might help people be a little bit less forgetful. Patients who take Leqembi will need to undergo several brain scans and travel to receive the drug at an infusion center.

    Medicare’s registry will help scientists better understand the safety and efficacy of Leqembi. But, curiously, the Alzheimer’s Association is seemingly not interested and opposes the registry, claiming it will create a barrier to access.

    People with Alzheimer’s who are overweight or who smoke and people with hypertension or diabetes, could slow cognitive decline by losing weight, stopping smoking and/or treating their hypertension and diabetes.

    Leqembi comes with a price tag of $26,500 a year. The Medicare program is expected to spend $500 million on Leqembi this year and $3 billion on it next year. If so, Medicare Part B premiums will rise significantly because of this one drug over time, as will premiums for Medicare supplemental coverage.

    Here’s more from Just Care:

  • Are weight-loss drugs a modern-day miracle?

    Are weight-loss drugs a modern-day miracle?

    Pretty much everywhere I turn, there’s a new story about the benefits of weight-loss drugs beyond helping people lose weight. It’s still early days, and many weight-loss drugs are extremely expensive. But, if you believe the stories, weight-loss drugs can treat heart conditions, can reduce overall health care spending and, can even treat depression and dementia, reports Simar Bajaj for the New Scientist.

    For now, Medicare covers weight-loss drugs mainly for people with diabetes. They are super expensive, driving up insurance premiums considerably, and there’s a lot we still don’t know about them. Still, what’s coming out about their benefits seems nothing short of a miracle.

    Some former alcoholics and drug addicts appear to lose their desire for alcohol and drugs when they take a semaglutide, a weight-loss drug, such as Wegovy and Ozempic. Their depression and anxiety fade away. So, can their addiction.

    Today about six million Americans take a weight-loss drug or GLP-1 medicine. Before long, it is projected that five times that number–30 million–Americans will be on a semaglutide. These drugs enable people to drop between 15 to 20 percent of their body weight.

    Back in February, Epic, which keeps Americans’ medical records, determined that people who took a GLP-1 were considerably less likely to suffer from depression and anxiety than others.  An earlier study arrived at similar findings. 

    Time will tell before we know for sure whether weight-loss drugs deliver all these findings. For now, it seems that the findings make sense. People who are overweight are more prone to depression. If they lose weight after taking a GLP-1, it’s more than likely that it will benefit them mentally as well as physically. For most of us, it feels good to lose weight.

    Some scientists believe there’s more to the story. GLP-1s are produced in the brain as well as the gut. So when you take a GLP-1 drug, you could be benefiting your brain directly, improving cognitive functions and emotional control. Indeed, in a small study of people who did not lose weight from a GLP-1, the researchers still saw improvements to their moods, and they experienced fewer depressive symptoms.

    GLP-1s have been found to increase blood flow in the brain as well as to keep nerve cells from dying as quickly as they otherwise do. They bring more glucose to the brain. As a result, the brain can function better. For these reasons, in small studies, GLP-1s have also been found to be responsible for less brain shrinkage in people with Alzheimer’s and to slow the progression of the disease.

    Again, these are early days. The good news is that these weight-loss drugs seem to have myriad benefits. And, for now, they also appear to come with few risks. But, if we know anything, it’s that what’s good for your health today might be found to come with serious side effects tomorrow.

    Here’s more from Just Care:

  • Caregiving: Keeping Parents Healthy – Water, Walking, Watch out for Delirium

    Caregiving: Keeping Parents Healthy – Water, Walking, Watch out for Delirium

    Just call me lunchmeat. Not that I’m complaining, but that’s sometimes how I feel after several years of the pressure and crunch of over-stuffed Sandwich Generation duties. Now my parents are settled into their new home,and the kids are alright. Although I’ve continued to practice geriatric psychiatry part-time, I feel like I can pry open those crusts of whole wheat and move some of those back-burner projects, like writing and sharing health care advice, to the front.

    My mother and father share a room in a nursing home, labeled the “Health Center,” in the continuing care community where they moved four years ago—I had to check my resume for the date—as it was when I last held a full-time job. Both have dementia. My father carries a diagnosis of Alzheimer’s disease. My mother has vascular dementia; her atrial fibrillation caused her heart to throw tiny blood clots to her brain, which led to “mini-strokes.”

    My parents have stayed out of the hospital for almost a year. This is a triumph for my sisters and me, and for the nurses, aides, therapists, and doctors involved in their care. I’ve come up with three basics (for starters here) that have contributed to keeping my parents healthy–water, walking and watching out for delirium. These were important when they were still in their apartment as well. They’re important for everyone.

    Water – Everyone’s heard this before but sometime’s it’s so incredibly hard to get older people (especially your mother!) to drink enough. As we age, we don’t get the ‘thirsty’ signal transmitted as strongly to our brains as when we were younger; it’s easier to become dehydrated. Lack of water can lead to low blood pressure and falls, to electrolyte imbalances and heart problems, to bladder and kidney infections, just to name a few.

    Women of my mother’s generation didn’t walk around with water bottles or some other container of liquid constantly in their hand like many of us do. In addition, as older bladders start to leak, and going to the bathroom requires help, they may hold back on fluids on purpose.

    It’s wise to ask the person you’re caring for what he or she likes to drink. As long as weight or diabetes or some other health issue isn’t a problem, give the person what she or he wants. Juices, tea, coffee, even soda, given that it’s not likely to be very much.

    A plastic cup like they have in hospitals has helped. The handle on the side makes it easy to grasp, and the top and the straw easy to sip from. Putting the person’s name on the cup and maybe a picture he or she likes can help get their attention. How about “Drink to Your Heart’s Content!” I like Alice in Wonderland; I’ll want Alice and a “Drink Me” tag on mine.

    Try to remember to offer (not just suggest) your mom (or dad) the cup as many times as is reasonable whenever you are visiting. Walk in with your own bottle (of water, juice, soda) and say, “I hate to drink alone”, or just “Cheers.”

    Walking – The maintenance of strength, balance, and flexibility as well as getting one’s heart pumping continue to be important whatever your stage of life. Exercise is at or near the top of the list for keeping your brain healthy too. An increasing number of studies show that exercise appears to slow the decline in memory and other brain functions in people who have dementia.

    My father continues to visit the same gym he frequented before joining my mother to live in the nursing home. He pedals the stationary bike and lifts light weights twice weekly with the encouragement and under the supervision of the physical training staff. He looks forward to going to see “the girls,” though he no longer remembers their names. One of my sisters or I must accompany him to the gym (and back), as the building is a couple of blocks from where he lives, and he can no longer navigate there himself.

    My mother goes to physical therapy twice weekly. The therapy room is in the same building as where she lives, so it’s easy for staff to come for her. It’s also another social outlet, with the therapists and other residents. The cost is out-of-pocket and about $60 an hour (per session), comparable to personal-training sessions. (But, Medicare should cover some physical therapy costs if your doctor prescribes it to maintain or restore function and it is provided by a Medicare-certified therapist.) My sisters and I also get both parents walking whenever we can—outside when it’s not too hot (in south Florida).

    Watching for delirium – When my mother told me, “They took me in the middle of the night to a shack in the boonies, a place in the swamp with nothing around except grass that swished all night with the rain . . . ,” I called her doctor to tell her my mother very most likely had another bladder infection and needed to be treated ASAP.

    Although she was speaking perfectly coherently on the phone, my mother had been delirious the night before. She could acknowledge the improbability of the swamp scenario, although she kept referring to it. Her nurse said she had no fever, hadn’t been needing the bathroom more than usual, nor did she feel any burning sensations. This lack of specific symptoms is common in people her age.

    It’s also common for family members to be the ones to notice that mom is expressing strange ideas, or is looking more sleepy or acting more irritably than her usual self. In nursing homes, bladder, or urinary tract infections, are the most common cause of sepsis, which is infection getting into the blood and possibly into other organs. These infections account for one-third of hospitalizations of patients in long-term care facilities, and studies show mortality rates ranging from 4 to 15.5%.

    Dementia is the strongest risk factor for delirium. Even after recovering from an acute episode of an infection with delirium, brain function often worsens. Each time a person becomes delirious, it’s like the tide goes out a little further on his or her brain and never quite comes all the way back in. Besides infections, dehydration can lead to delirium, as can malnutrition, drug reactions, and lack of sensory stimulation, which can occur in an intensive care unit or with very impaired eyesight or hearing

    More about risk factors for delirium and how to recognize it can be found here from the Hospital Elder Life Program for Prevention of Delirium.

    This article first appeared on Just Care on April 3, 2015.

    Here’s more from Just Care:

  • Beware experimental Alzheimer’s drug trials

    Beware experimental Alzheimer’s drug trials

    Melody Peterson reports for the LA TImes on how pharmaceutical companies enlist Californians with Medicare to participate in a clinical trial for experimental drugs intended to stave off Alzheimer’s. Ads promote drug trials for people who are losing their memories, as a way to keep their minds sharp. But, participating in an experimental Alzheimer’s drug trial carries serious risks.

    The pharmaceutical companies see Alzheimer’s drugs as a mega-opportunity to generate outsized profits. The six million-person market is huge and only growing. There’s little limit on what pharmaceutical companies can charge for these drugs. And, if FDA-approved, Medicare must cover them when medically reasonable and necessary.

    Already, the FDA has approved Aduhelm and Leqembi, which costs $26,000 a year, even though neither drug shows significant benefits and both can have serious side effects. Now, the race is on for pharmaceutical companies to market other drugs. But, the pharmaceutical companies need nearly 60,000 individuals to participate in the clinical trials of the 140 drugs being developed that are still experimental. 

    No question that if an Alzheimer’s drug works well, it could improve and extend the lives of people with Alzheimer’s and, arguably, save the health care system money as well. But, the clinical trials are not designed to treat people, only to test a drug’s efficacy. In fact, the trials can severely harm people.

    Some believe the Leqembi trials were responsible for the death of three people, though the drug’s manufacturer claims Leqembi was not likely the cause of their deaths. Four in ten participants in the Aduhelm trials experienced brain bleeding or swelling.

    Do trial participants understand that these experimental drugs come with a risk of brain swelling or bleeding? Is there a financial conflict of interest for the trial investigators who could make big money from the experimental drugs when they recruit trial participants? Do they overpromise?

    One recruiter offers older adults free meals and health tips. Pharmaceutical companies pay for the costs of recruitment activities. Then, their agents get people who are interested in participating in a clinical trial to sign a long consent form.

    But, how can you expect people who are struggling with memory issues to understand the consent form? They’re likely unaware of what they are signing. For that reason, federal regulations forbid people’s enrollment in a clinical trial if they lack the mental ability to understand a consent form, unless someone who has the legal authority to consent on their behalf does so.

    But, the clinical trial recruitment team is not required to have an independent monitor overseeing recruitment activities. And, it is not in their interest financially to ensure that the people they recruit have the ability to understand a consent form. The recruiters generally receive between $40,000 and $75,000 for every person they recruit to participate in a trial.

    What’s equally concerning is that the FDA can approve a drug like Leqembi, even when, based on the findings, experts question whether its benefits are meaningful. When a pharmaceutical company invests in a clinical trial, it does not need to release information on the results. To hide the results when they do not appear favorable, the pharmaceutical company can simply stop the trial.

    Here’s more from Just Care:

  • Bernie Sanders blasts drug manufacturers for the “unconscionable” price of Alzheimer’s drug

    Bernie Sanders blasts drug manufacturers for the “unconscionable” price of Alzheimer’s drug

    CNBC.com reports that Senate HELP committee chair, Bernie Sanders, is blasting drug manufacturers Eisai and Biogen for setting the price of its Alzheimer’s drug  at a level that will prevent people with Medicare from being able to get it. He wants the US Department of Health and Human Services to lower the price of Leqembi down from its “unconscionable” current price of $26,500 a year. 

    Like Aduhelm, Leqembi is a prescription drug administered by a physician and therefore covered under Medicare Part B. Medicare covers 80 percent of the cost, and individuals must pay 20 percent coinsurance. People’s annual out-of-pocket costs for Leqembi alone would be more than $5,000, unless they have Medicare supplemental coverage.

    Right now, the price of Leqembi will drive up Medicare spending significantly, along with Medicare Part B premiums. It will also contribute to the erosion of the Medicare Trust Fund. Medicare will be spending more than it spent on the three most costliest Part B drugs in 2021.  And, though the government has the right to negotiate drug prices for the Part B and D drugs it spends the most on, it will not be able to negotiate the price of Leqembi for 13 years, given restrictions on drug price negotiation in the Inflation Reduction Act.

    As I wrote earlier this year when the FDA approved Leqembi, “Keep in mind that after the FDA approved Aduhelm, the government adjusted the Medicare Part B premium up $11 a month! Its list price was $56,000 a year, and the government assumed hundreds of thousands of people would take it.” (Thankfully, Medicare did not end up covering Aduhelm because of health risks associated with taking it and only minor benefits at best.) “This year, the standard Part B monthly premium is down $5.20 because the government adjusted it to account for the fact that Medicare is not covering Aduhelm.”

    Sanders wants manufacturers to voluntarily reduce Leqembi’s price. If not, he wants the US Department of Health and Human Services to use its authority to break the drug’s patent in order to drive competition in the market. Sanders also suggests that the Centers for Medicare and Medicaid Services (CMS) has the authority to pay less for Leqembi. It is possible, though not likely, that a similar Eli Lilly drug, donanemab, that has not yet gone to market will help drive down Leqembi’s price.

    How many people with Medicare would get Leqembi? We don’t yet know how many people with Medicare will take Leqembi. Medicare is covering it for “patients with mild cognitive impairment or mild dementia with confirmed amyloid plaques,” which could be a large cohort of the 6.7 million people with Alzheimer’s disease. The Kaiser Family Foundation estimates that if one in 20 people with Medicare take it, it would cost the Medicare Part B Trust Fund $8.9 billion annually.

    About half of people with Medicare have an annual income under $30,000. They would be hard-pressed to afford coinsurance of more than $5,000. Even if they have Medicare supplemental coverage to pick up the coinsurance, the cost of their supplemental coverage is likely to rise significantly, given the cost of Leqembi and the number of people with Medicare who might take it.

    What is the fair price for Leqembi? The Institute for Clinical and Economic Review suggests that the fair price for Leqembi could be as low as $8,900 a year. Even at that price, it would mean nearly $1,800 a year in out-of-pocket costs for people taking it.

    Here’s more from Just Care:

  • FDA approves new Alzheimer’s drug

    FDA approves new Alzheimer’s drug

    Katherine Ellen Foley reports for Politico that the FDA just approved an Alzheimer’s disease drug that appears to show a small benefit to some people in the early stages of Alzheimer’s. That said, the drug, Leqembi, is expensive and comes with grave side effects for some people. For now, Medicare is not covering the drug, except for people in a Leqembi clinical trial.

    Keep in mind that after the FDA approved Aduhelm, the government adjusted the Medicare Part B premium up $11 a month! It’s list price was $56,000 a year, and the government assumed hundreds of thousands of people would take it. Thankfully, Medicare did not end up covering it. And, this year, the standard Part B monthly premium is down $5.20 because the government adjusted it to account for the fact that Medicare is not covering Aduhelm.

    Leqembi has now undergone three clinical trials to demonstrate clinical benefits, as required by the FDA for drugs approved through an accelerated process. The third trial shows modest clinical benefits and reduction of amyloid proteins in the brain. FDA approval is only for patients in the early stages of Alzheimer’s disease, with evidence of amyloid proteins in their brains.

    Leqembi has a launch price of $26,500 a year. It is infused into a patient’s body every two weeks.

    Eisai and Biogen manufacture the drug. These are the same companies that manufactured Aduhelm, which the FDA approved against the advice of its advisory committee. Medicare refused to cover Aduhelm, except in clinical trials, seemingly because of serious side effects and unremarkable clinical benefits.

    About one in seven people in the Leqembi trial suffer side effects, including swelling and bleeding of their brains. At the same time, about one in nine people who received a placebo in the trial also suffered from brain bleeding and swelling.

    Three people in the trial on Leqembi have died. It’s unclear whether Leqembi caused their deaths. Leqembi appears to reduce the rate of cognitive decline, though only by a modest amount. It also appears to keep Alzheimer’s-related proteins from gathering in the brain.

    Here’s more from Just Care:

  • Ultraprocessed foods are likely bad for your brain

    Ultraprocessed foods are likely bad for your brain

    It’s hard to avoid eating ultraprocessed foods. They can be very delicious. Who can resist a candy bar, french fries, ice cream, or doughnuts? But, Sandy LaMotte reports for CNN on the latest research study in JAMA Neurology showing that ultraprocessed foods are bad for your brain and might be increasing your risk of dementia and Alzheimer’s disease.

    Adults typically consume about 2,000 calories a day. If at least 400 of those calories (20 percent) are from ultraprocessed foods, you could be at greater risk of losing basic cognitive functions, including your ability to process information and make decisions.

    It’s easy to consume a lot of calories from ultraprocessed foods. If you’re a sucker for a McDonald’s cheeseburger sand small fries, for example, together they total 530 calories! As it turns out, ultraprocessed foods represent 58 percent of the typical American’s diet.

    How serious is the cognitive decay from eating a lot of ultraprocessed foods? The JAMA observational study found that people who ate a lot of ultraprocessed foods lost the ability to process information 25 percent faster than those who ate the least amount of ultraprocessed foods. Overall, cognitive impairment for those who ate the most ultraprocessed food came 28 percent faster than for those who ate the least.

    This all said, if you generally eat a healthy diet but combine healthy foods with ultraprocessed foods, you could be in luck when it comes to your mental health. The study found no cognitive decay associated with people who ate a lot of whole fruits and vegetables, healthy proteins and whole grains, along with ultraprocessed foods.

    While it’s an observational study that cannot directly tie eating ultraprocessed foods with cognitive decay, the findings should be taken seriously. The study involved 10,000 participants for as long as ten years. Compelling evidence!

    Participants’ average age was 51. The researchers defined ultraprocessed foods as “industrial formulations of food substances (oils, fats, sugars, starch, and protein isolates) that contain little or no whole foods and typically include flavorings, colorings, emulsifiers, and other cosmetic additives.” Ultraprocessed foods tend to have a lot of sugar, salt and fat, which cause inflammation in the body and jeopardize healthy aging.

    Putting aside cognitive decay, ultraprocessed foods should be avoided for many reasons. Among others, they increase your risk of heart disease, diabetes, cancer and death.

    Here’s more from Just Care:
  • What are the signs of dementia?

    What are the signs of dementia?

    As we age, it is all too common to think that we are beginning to suffer from dementia.  Please be assured that small memory lapses are not signs of dementia.  What are the symptoms? Dementia is an umbrella term for a group of neurodegenerative brain syndromes that affect memory, thinking, behavior and emotion.

    Every person will experience dementia in a unique way, and symptoms can vary among different types of dementia. However, there are general similarities between and within types of dementia.

    Alzheimer’s Disease is the most common form of dementia, accounting for 50-75% of all cases. Other types of dementia include vascular dementia, dementia with Lewy bodies and fronto-temporal dementia. Together, Alzheimer’s Disease and vascular dementia make up over 90% of all dementias.

    The most common signs of dementia are memory loss and the loss of ability to carry out practical skills, which can lead to withdrawal from work or social activities. If you suspect these symptoms in yourself or a loved one, speak to your doctor about the possibility of a dementia assessment.

    The most common early symptoms of dementia include:

    • Memory loss: Memory loss, especially short-term memory loss, is the most common early symptom of dementia.
      • Example: A person with dementia may forget a conversation she had with her friend yesterday, as well as the time and place of the conversation.
    • Difficulty performing familiar tasks: People with dementia may forget how to do tasks that are normally so familiar we do them mindlessly.
      • Example: A person with dementia may forget how to prepare his breakfast, though he has done this every day for years in the past.
    • Difficulty with language: People with dementia sometimes forget simple words or substitute words in the wrong way.
    • Problems keeping track of things: A person with dementia may have trouble with usual tasks, such as bill paying, or putting things in their correct place.
      • Example: A person with dementia may place her keys in an unusual location, such as the fridge, rather than in their normal place near her bedside.
    • Changes in mood, behavior or personality: People with dementia can show differences in mood and personality, including rapid mood swings, increased suspicion, irritability or anxiety. A person with dementia may also experience less emotion than usual.
      • Example: A person with dementia has trouble remembering where he put his glasses, resulting in more agitation and frustration than usual.
    • Disorientation to time and place: Disorientation to time and place is sometimes a symptom of dementia. People with dementia may become lost in familiar places or confuse night and day.
      • Example: A person with dementia may forget the way home from work.
    • Poor judgment: A person with dementia may exhibit instances of poor judgment.
      • A person with dementia may dress in many layers even though it is warm out.
    • Decreased initiative: People with dementia may lose the motivation to perform day-to-day activities, perform hobbies, or engage in social activities.
      • Example: A person with dementia who normally loves to paint may express apathy towards beginning a new painting project.

    There are several benefits to early diagnosis of dementia, which you can read about here. Over time, symptoms worsen, resulting in the progressive loss of ability to carry out day-to-day activities. If someone you know has dementia, here are some tips to help make sure they are safe at home.

    [Editor’s note: This post was originally published on May 28, 2015]

  • New Alzheimer’s drug shows promise at slowing cognitive decline

    New Alzheimer’s drug shows promise at slowing cognitive decline

    Damien Garde and Adam Feuerstein report for Stat News on likely FDA approval of a new drug to treat Alzheimer’s disease. In a clinical trial, the drug was shown to slow cognitive decline by 27 percent. Biogen and Eisai developed the drug, which they call lecanemab.

    Earlier this year, Biogen tried unsuccessfully to get FDA approval of Aduhelm to treat Alzheimer’s disease. But, Aduhelm showed limited at best clinical benefits and serious side effects.

    The clinical trial for lecanemab involved 1,800 patients with early-stage Alzheimer’s disease. It showed that patients fared better in terms of memory loss than patients who did not receive the drug. It also showed toxic plaque (amyloid) reduction in the brain and other benefits in terms of preserving memory and brain function.

    One in five patients who received lecanemab had brain swelling or bleeding. But fewer than three in one hundred showed symptoms.

    The FDA has said it will decide whether to conditionally approve lecanemab by Jan. 6. With new data, it could give full approval to lecanemab by the summer.

    The trial showed that patients who received lecanemab performed .45 points better on memory, problem-solving and personal care than patients who received the placebo, out of a total score of 18. The .45 point improvement is considered statistically significant, but this improvement may not be noticeable in a patient. Some experts believe the data available shows minimally significant positive results and want more data.

    Patients receive lecanemab twice a month through infusion.

    Here’s more from Just Care:

  • Biden administration says Part B premiums will drop in 2023

    Biden administration says Part B premiums will drop in 2023

    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: