Many insurers continue to hesitate in providing coverage for Aduhelm, the recently approved medication developed by Biogen (NASDAQ:BIIB) and Eisai (OTCPK:ESALY) for Alzheimer’s disease, Bloomberg reported citing a News Survey.
In the study, none of the 25 large insurers termed the treatment as “medically necessary,” while some have called the 56K/ year medication experimental. Others have said that they are still reviewing it.
Payors have pointed to the uncertain clinical benefits and potential side effects for rejecting Aduhelm, which became the first FDA-approved therapy in June since 2003.
Anthem (NYSE:ANTM), CVS Health (NYSE:CVS), and Centene (NYSE:CNC) were among some of the large insurers that have not publicly disclosed their position on the drug and did not take part in the survey.
The nation’s largest insurer UnitedHealth Group (NYSE:UNH) maintained the drug was still under its review for coverage, and the company was awaiting guidance from Medicare which is expected to set its policy by April. However, Humana (NYSE:HUM) provides coverage for its members who are likely to benefit from the therapy.
On Thursday, Biogen (BIIB) announced a negative trend vote adopted by an expert panel of the European Medicines Agency (EMA), signaling a potential hurdle in its bid to secure approval for the drug in the region.