Medicare resources say that a change to Medicare in 2017 was the addition of care planning as a service. Care planning helps patients to understand both what their medical options are, as well as alternative treatments, clinical trials, and even non-medical support.
Medicare won’t necessarily pay for all these services, but will pay to put together a plan to access them.
For persons with Alzheimer’s and their families, care planning is a much needed as well as much overlooked benefit.
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The Food and Drug Administration (FDA) approved Biogen’s new Alzheimer’s drug, Aduhelm, back in June. So many doctors in the fieldwhom argued that Biogen had failed to demonstrate whether the drug had any clinical value.
Since then, only about a hundred Americans have been prescribed the medication — a vanishingly small amount for a disease that afflicts 5.8 million.
But even as the scope of Aduhelm’s use remains limited, critics are now warning that its fiscal implications could spell disaster for American healthcare as we know it.
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Aduhelm alone, priced at a whopping $56,000 a year, has already contributed to an approximate $10 spike in monthly Medicare Part B premiums, according to a recent CNN report.
The drug will bring the monthly cost of Medicare up from $148.50 to $170.10 — the biggest jump in dollar terms throughout the program’s entire history, according to NBC15.
It should be noted that the $10 upcharge applies to all Medicare enrollees — that is, over 62 million Americans — most of whom will never directly benefit from Aduhelm.
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Medicare recipients are typically required to cover 20% of Part B treatments as part of the program’s co-insurance policy, Aduhelm patients have to cough up an extra $11,600 out of pocket annually.
Experts say that the U.S. healthcare system cannot afford to absorb Aduhelm.
However, Biogen says that Alzheimer’s care pathway is complex and underdeveloped.
“We anticipate that adoption of ADUHELM, like other novel treatments, will be gradual over many years, as system-readiness and diagnosis will take time, and we expect that only a fraction of the total eligible population will be treated with ADUHELM in 2022,” Allison Parks, the Biogen representative, said.
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