Health insurers leery of Aduhelm, but don't know how to cover it yet

Photo: Bill Clark/CQ Roll Call via Getty ImagesThe head of the health insurance industry's main lobbying group doesn't think the $56,000 annual price tag for Biogen's unproven Alzheimer's treatment, Aduhelm, is justified, but the group won't call on insurance companies to deny coverage of it.The big picture: Instead, insurers are relying heavily on Medicare and an independent drug pricing group for their coverage decisions.This interview was with Matt Eyles, CEO of America's Health Insurance Plans, and has been edited for brevity and clarity.Axios: What are your thoughts on the FDA approval of Aduhelm?Matt Eyles: We were surprised like many were, especially given what the advisory committee came out with. But I think people will be looking at what ICER puts out there.Photo: Sarah Silbiger/Getty ImagesFDA statisticians did not believe experimental Alzheimer's treatment Aduhelm proved that it could slow down the cognitive disease, but the top brass at the agency thought there was enough evidence to approve the drug anyway, according to internal documents released by the FDA today.Why it matters: Outside experts almost unanimously voted down the drug, and the scientific community has blasted the FDA's approval of Aduhelm. Photo: Sarah Silbiger/Bloomberg via Getty ImagesSenate Majority Leader Chuck Schumer (D-N.Y.) is working with Sen. Bernie Sanders (I-Vt.) to add dental, vision and hearing health coverage to Medicare, the New York senator announced Sunday.Why it matters: Schumer said the effort is meant to close "a gaping hole" in the health insurance program that covers millions of Americans age 65 and older.