Key Points
April 21 (Reuters) - Eli Lilly and Co (LLY.N) expects the U.S. Medicare health plan to back down from strict coverage limits on new Alzheimer's drugs as more evidence emerges in coming weeks showing that clearing amyloid brain plaques can help patients, a company executive told Reuters...
More study data on Leqembi, a rival drug from partners Eisai Co Ltd (4523.T) and Biogen Inc (BIIB.O), is also expected in the coming months...
"We believe that they (Medicare) will provide what we would call outright coverage like they do for every other FDA-approved medication," Derek Asay, Lilly's senior vice president of government strategy and federal accounts, said in an interview..
Currently, Medicare - the government health plan for Americans 65 and over - will only pay for anti-amyloid drugs approved under the FDA's less rigorous accelerated review if patients are enrolled in a clinical trial...
Under its coverage framework, CMS is looking for answers to three key questions: Do the drugs meaningfully improve health outcomes, such as slowing decline of cognition and function, for patients in a broad community practice?.
