Anthem Chief Executive Officer Gail Boudreaux said in a conference call that Anthem is closely watching for guidance from the U.S. Food and Drug Administration and all available clinical evidence on Biogen Inc’s Aduhelm to determine its coverage policy on the newly approved Alzheimer’s drug.
- Revenue: Anthem’s revenue in the second quarter increased 16% year over year, totaling almost $34 billion. Profit was down 21% from the same period last year, hitting $1.8 billion. Like UnitedHealth, more patients got care this year whereas the pandemic kept most people indoors and away from doctors last year.
- Insurance: Anthem now insures 44.3 million people, up 4.4% from a year ago. But most of those gains came in its private Medicare and Medicaid plans. Anthem continues to lose people in job-based plans.
- Concerning matter: The controversy lies with the premature and expedited approval process for this particular drug. There are a few reasons for concern. One is that there are uncertainties regarding the clinical benefits of Aduhelm.”As new information becomes available, we’re going to continue to evaluate it with our clinical experts,” Anthem Chief Executive Officer Gail Boudreaux said in a conference call.
- Separate policies: Several insurance companies like Aetna, Anthem Blue Cross, Blue Shield, UnitedHealthcare, Kaiser Permanente and others will likely approach Aduhelm differently. They have separate policies called “medical” or “pharmacy” policies. These policies include internal clinical guidelines on the parameters and circumstances in which medications and treatments are “medically necessary.” As Aduhelm gets approved by their own guidelines, they would start covering it.
- Approval: The Food and Drug Administration (FDA) approved the first new Alzheimer’s drug, Aduhelm, in nearly 20 years on Monday, June 7, 2021. The medication is from Biogen and was developed by Biogen and the Japanese company Eisai Co. The drug’s scientific name is “aducanumab” and it is marketed as “Aduhelm.” The accelerated approval was based on study results showing Aduhelm was “reasonably likely” to benefit people with Alzheimer’s.