Public Policy Solutions Co-Founder and President Joe Grogan and Dr. Paul Aisen argue in their latest op-ed, “Alzheimer’s Drugs Deserve a Second Opinion,” that outdated Medicare policies are keeping promising treatments out of reach for patients who could benefit from them.
In their op-ed, Joe and Dr. Aisen argue:
For years, many policymakers, health plans, and physicians have questioned whether a new class of Alzheimer’s drugs provides meaningful benefits. But the latest clinical evidence deserves a closer look.
Two treatments, donanemab and lecanemab, have been shown in randomized clinical trials to slow the progression of early-stage Alzheimer’s disease by approximately 30 percent. The treatments are not right for every patient and require careful monitoring, but they can give eligible patients more time to live independently, remain active in their communities, and stay connected with their families.
Despite this progress, Medicare continues to restrict access through its Coverage with Evidence Development program. The policy requires patients to enroll in a Medicare-approved registry before receiving coverage, creating a significant barrier, especially for seniors in rural communities who may not have access to a participating clinician.
Joe and Dr. Aisen call on the Centers for Medicare & Medicaid Services to reconsider these restrictions and use standard post-approval research to monitor the treatments’ safety and effectiveness.
They also urge Congress to pass the ASAP Act, which would allow Medicare to cover Alzheimer’s screening. Earlier diagnosis, aided by new tools such as blood tests and AI-powered cognitive assessments, would help patients begin treatment when it is most likely to make a difference.
Patients and their doctors should be able to make informed treatment decisions based on the evidence. America’s healthcare system should build on medical progress, not place unnecessary obstacles in its way.