Medicare has decided to sharply limit coverage of Aduhelm, a new Alzheimer drug

Medicare has decided¹ to sharply limit coverage² of Aduhelm, a new Alzheimer drug

Transcript³

Medicare officials announced on Thursday that the health insurance program for older Americans will sharply limit coverage of a costly⁴ and controversial new Alzheimer's drug.

LEILA FADEL, HOST:

The nation's Medicare program for older Americans has decided to sharply limit coverage of a new Alzheimer's drug. The decision announced yesterday comes after months of debate about the costly and controversial drug. Joining us now to explain is NPR science correspondent Jon Hamilton. Hi, Jon.

JON HAMILTON, BYLINE⁵: Hi.

FADEL: So, Jon, remind us about what this drug is that we're talking about.

HAMILTON: OK. The drug is called aducanumab, though it's probably better known by its brand name Aduhelm. And what this drug does really well is remove those sticky plaques⁶ that build up in the brains of Alzheimer's patients. What it may not do so well is actually preserve a person's memory and thinking. There's been a lot of debate about that. So a lot of people were surprised when the Food and Drug Administration approved the drug last year even though the FDA's own advisory⁷ committee said that was a bad idea. Then in January of this year, the Centers for Medicare and Medicaid Services - that's the agency that oversees⁸ these government health programs - it made a preliminary ruling that Medicare would cover the drug but only for patients enrolled¹⁰ in a clinical trial.

FADEL: So what happened yesterday?

HAMILTON: Yesterday, CMS, the Centers for Medicare and Medicaid Services, basically affirmed its earlier decision. And I should say, this came after reviewing a lot of input¹¹ from doctors and patients and Biogen, the company that makes Aduhelm. The government got something like 10,000 comments about the drug, which is unusual. And the drug's price, which is originally $56,000 a year, was cut in half. Even so, at the announcement yesterday, health officials repeated what they had said in January - they just aren't prepared to authorize¹² full coverage for a drug that hasn't been proved effective and has dangerous side effects, like bleeding and swelling¹³ in the brain. CMS did make a couple of small concessions¹⁴, though. One was to change a part of the earlier decision that said coverage would be limited to people in studies that the agency itself approved. In this version, they said they would accept any study done as part of an FDA review or done by the National Institutes of Health.

FADEL: So what does this mean for patients?

HAMILTON: It won't mean anything for patients in the later stages of Alzheimer's. That's because the drug is only approved for people in the earliest stages of the disease. And for them, the effect depends on who you ask. The Alzheimer's Association put out a statement saying the decision is creating, quote, "unnecessary barriers" for people with Alzheimer's. They say Medicare is willing to cover last-ditch cancer drugs so it should cover this drug, too. On the other hand, a lot of neurologists - you know, those are the doctors who often treat Alzheimer's - agree with the decision, and so do a lot of scientists, who say the FDA should have waited until it had clear evidence that Aduhelm makes a difference in people's lives. And yesterday's decision may not even be the biggest obstacle for patients who want Aduhelm. Some prominent medical institutions, like the Cleveland Clinic, are simply refusing to prescribe it. And sales of the drug have been really poor so far.

FADEL: So what happens now? Is this a done deal?

HAMILTON: It's not quite a done deal. Obviously, the decision will have a huge impact in the short term, and that's because Alzheimer's primarily affects people who are older than 65 - in other words, Medicare patients. But Aduhelm's eventual¹⁵ fate may come down to a new clinical trial, which is just beginning to enroll⁹ patients now. It's being done by the drug's maker¹⁶, Biogen. There were two previous trials, I should say. One showed the drug worked; one showed it didn't. This is supposed to be the tiebreaker. And Medicare could change its mind if the results are positive. But these drug trials take years to complete. So by the time this is done, you know, it's possible that other similar drugs will already be on the market. And by the way, Medicare says its decision about this drug will apply to other similar drugs as well.

FADEL: NPR's Jon Hamilton. Thank you.

HAMILTON: You're welcome.

1 decided   

adj.决定了的，坚决的；明显的，明确的

参考例句：

• This gave them a decided advantage over their opponents.这使他们比对手具有明显的优势。
• There is a decided difference between British and Chinese way of greeting.英国人和中国人打招呼的方式有很明显的区别。

2 coverage   

n.报导，保险范围，保险额，范围，覆盖

参考例句：

• There's little coverage of foreign news in the newspaper.报纸上几乎没有国外新闻报道。
• This is an insurance policy with extensive coverage.这是一项承保范围广泛的保险。

3 transcript   

n.抄本，誊本，副本，肄业证书

参考例句：

• A transcript of the tapes was presented as evidence in court.一份录音带的文字本作为证据被呈交法庭。
• They wouldn't let me have a transcript of the interview.他们拒绝给我一份采访的文字整理稿。

4 costly   

adj.昂贵的，价值高的，豪华的

参考例句：

• It must be very costly to keep up a house like this.维修这么一幢房子一定很昂贵。
• This dictionary is very useful,only it is a bit costly.这本词典很有用，左不过贵了些。

5 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

6 plaques   

（纪念性的）匾牌( plaque的名词复数 )； 纪念匾； 牙斑； 空斑

参考例句：

• Primary plaques were detectable in 16 to 20 hours. 在16到20小时内可查出原发溶斑。
• The gondoliers wore green and white livery and silver plaques on their chests. 船夫们穿着白绿两色的制服，胸前别着银质徽章。

7 advisory   

adj.劝告的，忠告的，顾问的，提供咨询

参考例句：

• I have worked in an advisory capacity with many hospitals.我曾在多家医院做过顾问工作。
• He was appointed to the advisory committee last month.他上个月获任命为顾问委员会委员。

8 oversees   

v.监督，监视( oversee的第三人称单数 )

参考例句：

• She oversees both the research and the manufacturing departments. 她既监督研究部门又监督生产部门。 来自《简明英汉词典》
• The Department of Education oversees the federal programs dealing with education. 教育部监管处理教育的联邦程序。 来自互联网

9 enroll   

v.招收；登记；入学；参军；成为会员（英)enrol

参考例句：

• I should like to enroll all my children in the swimming class.我愿意让我的孩子们都参加游泳班。
• They enroll him as a member of the club.他们吸收他为俱乐部会员。

10 enrolled   

adj.入学登记了的v.[亦作enrol]( enroll的过去式和过去分词 )；登记，招收，使入伍（或入会、入学等），参加，成为成员；记入名册；卷起，包起

参考例句：

• They have been studying hard from the moment they enrolled. 从入学时起，他们就一直努力学习。 来自《简明英汉词典》
• He enrolled with an employment agency for a teaching position. 他在职业介绍所登了记以谋求一个教师的职位。 来自《简明英汉词典》

11 input   

n.输入(物)；投入；vt.把(数据等)输入计算机

参考例句：

• I will forever be grateful for his considerable input.我将永远感激他的大量投入。
• All this information had to be input onto the computer.所有这些信息都必须输入计算机。

12 authorize   

v.授权，委任；批准，认可

参考例句：

• He said that he needed to get his supervisor to authorize my refund.他说必须让主管人员批准我的退款。
• Only the President could authorize the use of the atomic bomb.只有总统才能授权使用原子弹。

13 swelling   

n.肿胀

参考例句：

• Use ice to reduce the swelling. 用冰敷消肿。
• There is a marked swelling of the lymph nodes. 淋巴结处有明显的肿块。

14 concessions   

n.（尤指由政府或雇主给予的）特许权( concession的名词复数 )；承认；减价；（在某地的）特许经营权

参考例句：

• The firm will be forced to make concessions if it wants to avoid a strike. 要想避免罢工，公司将不得不作出一些让步。
• The concessions did little to placate the students. 让步根本未能平息学生的愤怒。

15 eventual   

adj.最后的，结局的，最终的

参考例句：

• Several schools face eventual closure.几所学校面临最终关闭。
• Both parties expressed optimism about an eventual solution.双方对问题的最终解决都表示乐观。

16 maker   

n.制造者，制造商

参考例句：

• He is a trouble maker，You must be distant with him.他是个捣蛋鬼，你不要跟他在一起。
• A cabinet maker must be a master craftsman.家具木工必须是技艺高超的手艺人。