More and more prescription drugs are coming to market with outrageous wholesale prices and many have wondered whether Medicare and private insurance companies will cover them. They got their answer on Friday for the new Alzheimer’s drug from Biogen when The Department of Veterans Affairs said they won’t cover Aduhelm. Medicare has yet to weigh in. The VA cited the risks of causing series side effects and a lack of evidence that it improves cognitive function in denying coverage. By law, the VA has greater leeway than other government health programs like Medicare and Medicaid to deny coverage of medicines it deems to be of poor value. A group of VA doctors concluded last month that more than 150K veteran beneficiaries diagnosed with Alzheimer’s could receive the drug. However, it would come at a cost of $4 billion annually.
