Letter to Hon. Xavier Becerra, Secretary of the Department of Health & Human Services-Kildee Calls for Reversal of Medicare Part B Premium Increases

Letter

Dear Secretary Becerra:

As you know, in November the Centers for Medicare and Medicaid Services (CMS) announced the largest premium hike for Medicare Part B beneficiaries in the program's history. Medicare actuaries stated that the cause of this 14.5% increase was due to a combination of factors including higher utilization of the health care system, but a significant and new factor facing Medicare's finances is the cost of new Alzheimer's drug Aduhelm, initially priced at $56,000 per year. The extremely high price point and unknown size of the patient population eligible to receive it resulted in CMS actuaries determining that Medicare Part B beneficiaries must pay a historically large premium in order to ensure the cost of the new drug would not bankrupt the program. Although the announced premium increase would be offset by a larger increase in Social Security payments for most beneficiaries, it is undoubtedly a financial hardship compounding rising costs for seniors across the economy.

That is why we commend your directive that CMS reexamine the Part B premium in light of the announcement that Aduhelm's manufacturer, Biogen, would reduce its list price from $56,000 per year to $28,200. Given CMS' analysis of the impact that a $56,000 treatment would have on the Medicare Part B trust fund and the subsequent reduction in this price, asking the agency to reevaluate the system's financial needs is the right move for beneficiaries.

Shortly after your announcement, CMS made a preliminary determination that Medicare will cover Aduhelm for patients with mild cognitive impairment who are enrolled in a clinical trial as the agency learns more about the safety and efficacy of the drug. This decision along with the recent reduction in list price provide hope that the drastic impact on Medicare's finances could be blunted. While this request to review the actuarial data after the start of the new year is unprecedented, it is warranted in order to ensure seniors are not asked to pay more than they can afford as a result of one company's pricing decisions. We are hopeful that this review from CMS results in a reduction of the 2022 Part B premium.

Although we remain concerned about the financial impact of high price products like Aduhelm on both the Medicare system and patients, we are grateful for your decision to take a second look at how changes in Aduhelm's pricing and utilization could obligate a reduction in the 2022 Medicare Part B premium for American seniors.

Thank you for your leadership,