Update for Week Ending April 9, 2022

Update for Week Ending April 9, 2022

Congress Begins Two-Week Break

Congress began a two-week break starting today, Monday. While committee work will continue, there will be no votes on the floor of either house until they return.

Many of the members will be in their home states or districts so if you call one of their local offices you may be able to schedule a meeting with them. This would be a good opportunity to express your concern about passing legislation to lower prescription drug prices as well as the need for more help for seniors who have suffered so much from the Covid pandemic.

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CMS Continues Limited Access to Alzheimer’s Drug

We have reported in the past about the controversial drug Aduhelm, whose benefits for Alzheimer’s sufferers have been widely questioned in the medical community.

In January, the Centers for Medicare and Medicaid Services (CMS) announced an interim policy that Medicare would severely restrict the number of seniors who can access the drug because it planned to only cover the drug for patients participating in rigorous, agency-approved clinical trials.

When Aduhelm came on the market it was announced as the first new Alzheimer’s medication in nearly two decades. Initially priced at a whopping $56,000 a year, it was expected to quickly become a blockbuster drug, generating billions for the drug company that developed it.

However, from the beginning, it has been controversial. The FDA approved the drug over the opposition of its own advisory panel. In fact, some members of the panel resigned in protest over the approval of the drug.

In addition, doctors have been hesitant to prescribe it, given weak evidence that the drug slows the progression of Alzheimer's and insurers have blocked or restricted coverage over the drug’s high price tag and uncertain benefit.

The drug company even cut the price of Aduhelm in half, to $28,000 per year, apparently with the hope that the lower price would encourage more sales.

Since the interim CMS decision in January there has been a huge lobbying effort in Washington on the part of Alzheimer patient advocates in an attempt to persuade CMS to cover the cost of the drug for all Alzheimer patients. But the uncertainty over the effectiveness of the drug seems to have led to last week’s decision.

This final CMS decision means that for Medicare to pay for the drug, patients taking Aduhelm will have to be part of clinical trials to assess the drug’s safety and effectiveness in slowing the progression of early-stage dementia.

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Is Cut in Medicare Part B Premiums on the Horizon?

At the beginning of this year, seniors enrolled in Medicare Part B saw the largest increase in their premiums dollar-wise in the program’s history.

As we previously reported, the large increase came about because of Medicare preparing to pay for the cost of the new drug, Aduhelm, that supposedly helps patients with Alzheimer’s disease.

However, the decision announced by CMS last week to continue to only cover Alzheimer’s patients enrolled in approved clinical trials means that the number of people receiving the drug will be many fewer than previously estimated.

As a result, Medicare said last week that it is considering a cut in enrollee Part B premiums. Lawmakers have called for a rollback and Health and Human Services Secretary Xavier Becerra already directed Medicare to reassess.

No date was given as to when a final decision might be made nor was there any indication as to how Medicare would go about implementing a lower premium or if the higher premium amount paid so far this year would be rebated in some manner to those enrolled in Part B.

TSCL strongly supports lowering the Part B premium and rebating the higher premiums paid so far this year in some fair and reasonable way.

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A Word of Caution: Covid-19 is Still With Us

We are all tired of it – tired of even hearing about it - and we want our lives to go back to normal. But we should remember that Covid-19 is still with us, even though it may be in the form of a new variant.

The rise of Covid cases in some regions of the U.S., just as testing efforts wane, has raised the possibility that the next major wave of the virus may be difficult to detect. In fact, the country could be in the midst of a surge right now and we might not even know it.

Testing and viral sequencing are critical to responding quickly to new outbreaks of Covid. But as the country tries to move on from the pandemic, demand for lab-based testing has declined and federal funding priorities have shifted.

Seniors need to remember that they are the most vulnerable group in the country when it comes to Covid and that we should not let our guard down.

So as a reminder, a second booster dose of the Covid-19 vaccine from both Moderna and Pfizer has been authorized by the Food and Drug Administration for adults 50 and over.

Those who have received a first booster shot at least four months ago can now get another.

Remember, booster doses are becoming an increasingly relied-upon tool in the fight against Covid, especially as states and companies cut back safeguards such as masking and working from home.

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As we continue dealing with the Covid 19 pandemic, TSCL remains constant in our fight for you to protect your Social Security, Medicare, and Medicaid benefits. We have had to make some adjustments in the way we carry on our work, but we have not, and will not stop our work on your behalf.

For progress updates or for more information about these and other bills that would strengthen Social Security and Medicare programs, visit our website at www.SeniorsLeague.org or follow TSCL Facebook or on Twitter.