UnitedHealth Says Aduhelm Coverage Decision Will Hinge on Medicare Guidance

During the company’s July 15 call to discuss second-quarter 2021 financial results, UnitedHealth Group executives — perhaps unsurprisingly — fielded a question about how the company is approaching Aduhelm (aducanumab), the pricey new Alzheimer’s disease therapy that continues to be shrouded in controversy.

Chief Medical Officer Richard Migliori, M.D., told analysts that “we are continuing to develop our clinical policy as well as our ultimate position on coverage, but in doing so we’re looking forward to getting the guidance that we need from Medicare.” CMS on July 12 said it was opening a National Coverage Determination analysis on Aduhelm, which will ultimately specify how Medicare will cover the $56,000 per year treatment. In the meantime, coverage will be determined at a local level by Medicare Administrative Contractors, the Biden administration said.

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