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Opinion: Two drugs could help Alzheimer’s. Why won’t Medicare cover them?

The FDA recently approved two drugs that could affect early-stage Alzheimer’s, but Medicare won’t cover them even if prescribed by a doctor

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A doctor looks at a PET brain scan at the Banner Alzheimers Institute in Phoenix.

A doctor looks at a PET brain scan at the Banner Alzheimers Institute in Phoenix on Aug. 14, 2018. The FDA recently approved two drugs that could affect early-stage Alzheimer’s, but Medicare won’t cover them even if prescribed by a doctor.

Matt York, Associated Press

The rollercoaster ride for 6.7 million Americans, including 34,000 Utahns, living with Alzheimer’s disease continues, but there’s a glimmer of hope courtesy of the Veterans Health Administration (VHA).

While there’s never been a survivor of Alzheimer’s, there’s good news: the FDA recently approved two drugs that show the ability to affect the course of early-stage Alzheimer’s.

Sadly, the Center for Medicare & Medicaid Services (CMS) has blocked Medicare coverage for the drugs even if doctors prescribe them. Only the privileged few able to enroll in clinical trials — or who can pay $26,500 out-of-pocket — have access.

Recently, the VHA announced it will cover the Alzheimer’s drug lecanemab under specific conditions for veterans over 65 diagnosed with early-stage Alzheimer’s.

The Alzheimer’s Association applauds the VHA’s step, but veterans are a small slice of those living with Alzheimer’s. Medicare has always covered FDA-approved treatments for those with conditions including cancer, heart disease and HIV/AIDS. Treating those with Alzheimer’s disease differently is unprecedented and unacceptable.

Please encourage your U.S. senator or representative to urge CMS to reconsider its position and provide open access to these momentum-changing medications. Each day that passes means that more people with early-stage Alzheimer’s will no longer benefit from them.

Stacie Kulp

Executive Director, Alzheimer’s Association of Utah