Brewing Alzheimer’s Drug Plan Fights Rest in Patients’ Hands

Biogen Inc.'s chances of seeing change to Medicare’s limited Alzheimer’s drug coverage will hinge largely on whether it can find patients who say they have been unreasonably denied access to the treatment.

The Centers for Medicare & Medicaid Services restricted coverage for Biogen’s Aduhelm and other treatments like it to patients in CMS-approved clinical trials. The move prompted pushback from Biogen and some advocacy groups that argue the decision will unfairly restrict access for minority and rural populations.

Biogen says it’s exploring its options and questions the legality of the CMS’s authority to condition coverage on additional studies. But policy ...