SARASOTA, Fla. — Sponsors of a bipartisan legislation want to limit Medicare reimbursement restrictions on certain drugs including ones for treating Alzheimer's.
Rep. Vern Buchanan, R-Sarasota, spoke more about the Mandating Exclusive Review of Individual Treatments Act or MERIT Act, Monday. Buchanan and Rep. Nanette Barragan, D-California, introduced the bill back in October.
Buchanan said the bill aims to change how the Centers for Medicare & Medicaid Services decide what drugs are covered.
Under the bill, it would require the agency to evaluate each new drug individually on its own merit and help give seniors a better quality of life, including the controversial Aduhelm and the new medication, Leqembi, for treating early onset Alzheimer's.
"If we could push it off for 10, 20, 30 years. Right now, they claim the drugs might do it for a year or half a year. Is it worth it? Yes," Buchanan said. "It's worth it for your mom or dad, or someone, to have it where they can communicate and have a sense of your real life here on earth."
Such access according to supporters of the bill would especially help people with early onset of Alzheimer's disease.
"I get frustrated. I can't turn on the TV to the thing that I want to turn it on to, so many things," Michelle Hall of Bradenton said.
Only in her mid-50s, Hall is already managing to live with memory loss induced by an early onset of Alzheimer's disease.
She said she's lucky to have worked with doctors who had put her on the FDA-approved medication Adulhelm which her doctor said is helping her. But a congressional investigation said the FDA's approval of the drug was rife with irregularities and CMS placed limits on what Alzheimer's drugs Medicare would cover.
"She would love to have the option to maybe switch to a new one or the one after that, which aren't being covered, so it's not an option right now, so we're lucky that we're on one," Doug Hall, Michelle's husband and caregiver, said. "The second one is a little bit better it looks like. There's a third one that's even better, which is also covered by CMS saying so no we're not going to cover it."
Doctors said an estimated 6.7 million Americans over 65 live with Alzheimer's disease and that number is expected to jump to nearly 13 million by 2050. It's also the leading cause of nursing home placement, according to Dr. Clifton Gooch.
"We do know that with it when the window is short, it is 18 months. About a 25% slowing and memory decline so it is putting the brakes on," Gooch, a professor and chair of Neurology and Associate Dean for Clinical Research at the University of South Florida Morsani College of Medicine, said.
Buchanan wants Medicare to cover new Alzheimer's drugs that now cost around $8,500 to anything between $20-30,000 for prescriptions.
The MERIT Act would see that each drug is treated independently and evaluated based on its individual merit and wider impact.
"I'm in the fifth oldest district in the country so our seniors are counting on it," Buchanan said. "If you can get it, I think early stages according to the doctor, what he said today, you can have an impact to make a difference."
The bill is being supported by various advocacy groups including the Alzheimer's Association and the Global Alzheimer's Platform Foundation.