Ep. 62 - The Battle Over Medicare Coverage: Should all FDA approved drugs be paid for?

The FLATLINING Podcast from Fulcrum Strategies

Matthew and Ron dive into the debate on whether Medicare should cover every FDA-approved drug, focusing on the case of Aduhelm and Leqembi, two Alzheimer's drugs. Aduhelm was is not covered by Medicare due to limited effectiveness and high cost. The Centers for Medicare and Medicaid Services announced Leqemebi would be in certain circumstances. Key highlights

• FDA approval does not guarantee that a drug should be used by everyone, it only indicates clinical effectiveness and acceptable side effects.

• Medicare's decision to deny coverage for certain drugs is based on cost-benefit analysis and clinical effectiveness.

• The case of Aduhelm, an Alzheimer's drug, highlights the importance of considering both the clinical value and cost of a drug.

• Registries can help ensure that drugs are given to the right patients and monitor potential side effects.

• The fragmented system of drug coverage and the need for a more unified approach.

• The importance of checks and balances in the healthcare system, including the role of the courts.

• The necessity of administrative levels and bureaucracy in healthcare organizations.

• The ongoing debate about the size and efficiency of the federal government.

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