New treatment for Alzheimer's Disease available, but Medicare denies unrestricted coverage for it

Alzheimer’s impacts nearly 6 million Americans over the age of 65, and that number is expected to triple by 2060. It is the sixth leading cause of death in the U.S., according to the CDC.

“It is always fatal. There is no cure. That's why we need to get more therapies. We, until recently, had not had a therapy approved by the FDA in over 20 years,” Dwyer said.“We started to notice there were a few details in Jenny’s memory that were falling through the cracks,” Joe Knap said. “Jenny was at very high risk for developing dementia and Alzheimer’s.”

But they weren’t going to hide from the diagnosis. Jenny Knap went to Cleveland Clinic and was eligible to be a part of a clinical trial for a new treatment. In a press release, CMS said there is not yet evidence meeting the criteria for reconsideration and CMS is required to examine whether a medication is reasonable and necessary. It said it will review any new evidence that becomes available that could lead to a reconsideration.“Medicare is taking a position with this whole class of drugs for the first time in history and said if the FDA approves it, it's not good enough for us. We're going to put up more barriers.

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