Medicare learns to say no, but why now, to patients with Alzheimer’s disease?


April 20, 2022 2:26 p.m. ET

A photo of Biogen, the maker of Aduhelm, in Cambridge, Massachusetts on December 12, 2019.


david a white/biogen/Shutterstock

The job of the Food and Drug Administration is to determine if a treatment is safe and effective. As your editorial “Sandbagging an Alzheimer’s Treatment” (April 14) notes, this is a clinical judgment.

Whether the treatment is cost-effective and should be paid for by the government or insurers is a political judgment, not a clinical judgment. “This is the first time CMS has restricted drug coverage in this way,” you wrote. It was time. The Centers for Medicare and Medicaid Services should spend the money where it will do the most good. That means cost-benefit analysis, which progressives aren’t known for embracing. They shouldn’t be criticized for doing it now.

S. Paul Posner

New York

Your op-ed highlights the political motivation behind CMS’s refusal to approve Medicare coverage for a promising drug for Alzheimer’s disease. It may be political, but it is certainly cruel. Alzheimer’s patients see their mental abilities eroding from the inside, gradually losing everything in the present, unable to remember the names of spouses, children and best friends, and ultimately unable to take full care of themselves. Death is a gift, but it does not compensate for the cruelty of their last years. Who else suffers? Their family and friends, who are suffering in a different way, fully aware, aware and alert all the time.

I practiced medicine for 49 years. I am horrified by the cruelty of CMS.

Douglas A. Kramer, MD

Middleton, Wis.

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