Aduhelm price drop prompts Becerra to rethink hike to Part B 2022 premiums

Biogen’s decision to halve the price of its controversial Alzheimer’s drug Aduhelm has the Biden administration rethinking the 15% hike for Part B premiums for 2022.

Department of Health and Human Services (HHS) Secretary Xavier Becerra announced Monday that he wants the Centers for Medicare & Medicaid Services (CMS) to reassess its proposed price hike.

“With the 50% price drop of Aduhelm on Jan. 1, there is a compelling basis for CMS to reexamine the previous recommendation,” Becerra said in a brief statement.

CMS announced in November that premiums for Part B for 2022 will increase from $148.50 to $170.10 and annual deductibles will also rise from $203 to $233.

Part B covers a slew of physician and hospital services and reimburses for drugs administered in a doctor’s office.

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CMS said at the time that the agency was making the cut in anticipation of hikes in drug costs for this year.

“There is significant uncertainty regarding the potential future of clinician-administered Alzheimer’s drugs (i.e., Aduhelm), requiring additional contingency reserves,” the agency said in a November statement.

CMS added that the monthly Part B premium must equal 25% of the estimated total costs for enrollees and the agency must “establish an annual Part B premium hat will adequately fund projected Medicare spending and maintain an adequate reserve in case actual costs are higher than estimated.”

The decision comes as CMS is expected to issue a decision on whether Medicare will cover Aduhelm soon.

The Food and Drug Administration controversially approved the drug last year despite concerns from the agency’s advisors over its effectiveness at combating the disease.

Biogen initially launched Aduhelm at a price of $56,000, but the drugmaker decided in December to halve that price to $28,200 starting on Jan. 1. The high price tag has drawn criticism, leading major health systems like Cleveland Clinic and Mayo Clinic to choose not to prescribe it.

HHS told Fierce Healthcare that it won't speculate on CMS' looming decision. 

"However, any change to the premium resulting from the reassessment due to the Aduhelm price decline would be based on actuarial principles, which would include the need for healthy trust fund reserves to ensure viability of the program in the future and allowing for a range of scenarios," the agency said.