A handful of Blue Cross and Blue Shield affiliates announced Aduhelm, Biogen's controversial Alzehimer's drug, would not be covered after being deemed experimental and investigational.
Recently, affiliates in North Carolina, Pennsylvania, Michigan, New York and Kansas all made the announcement, with other plans like Highmark and Care Network of Michigan only allowing its use with prior approval. The announcements largely affect commercial plans.
"We have evaluated the published peer-reviewed literature on the evidence of Aduhelm's safety and effectiveness in treating Alzheimer's disease," Independence Blue Cross said in its statement. "We have concluded that it does not sufficiently show that the drug's clinical benefits outweigh its harms or that it reduces progression of the disease."
The announcements echo a lack of research and evidence of benefits, earning the drug the experimental/investigational label and disqualifying it from coverage.