Blue Cross Blue Shield of Rhode Island announced that it will not cover the new Alzheimer’s medicine Aduhelm. Jill Flaxington, a spokesman for BCBSRI, Rhode Island’s largest private health insurer, stated in an email that the firm is waiting for a decision on Medicare coverage from the Centers for Medicare & Medicaid Services.
- Intake: The medicine, developed by Biogen in Cambridge, is designed to reduce cognitive deterioration in Alzheimer’s patients who are in the early stages of the illness. According to the Rhode Island Department of Health, Alzheimer’s disease affects around six million Americans, including approximately 24,000 Rhode Islanders.
- Refuse: Blue Cross Blue Shield affiliates in Massachusetts, North Carolina, Pennsylvania, Michigan, New York, and Kansas have indicated they won’t cover treatment at this time. In explaining its review process, BCBSRI states: “BCBSRI will evaluate our coverage decisions as more clinical data becomes available to determine whether [Aduhelm] achieves clearly demonstrated clinical benefit and safety.”
- Approvals: Despite the fact that none of the 11 members of the FDA advisory committee voted in favor of Aduhelm, the first new Alzheimer’s medicine in nearly 20 years, the Food and Drug Administration approved its usage in June 7. Three of the 11 members of the committee resigned as a result of the FDA’s decision to approve Aduhelm.
- Efficacy: “After review by a local, independent panel of health care providers to assess the health and safety of [Aduhelm], Blue Cross & Blue Shield of Rhode Island has designated [Aduhelm] non-covered based on an evaluation of safety and clinical efficacy for non-Medicare members,” Flaxington wrote.
- Reports: According to Dr. Stephen Salloway, director of the Butler Hospital Memory and Aging Program, four patients at Butler Hospital in Providence were receiving monthly infusions of Aduhelm as of Aug. 3, with more than 100 patients on the waiting list. Salloway did not indicate how many patients are now receiving the medicine on Friday.