No one has money to burn, especially with the high rates of inflation we are seeing these days. Despite that Medicare premiums saw the highest rate increase in its history for 2022. There’s a single medicine to blame.

2022 Medicare Price Hikes

Before we get started, it’s important to understand just how much rates increased from 2021 to 2022. The costs you pay toward Part B Medicare premiums are actually based on your income taxes from two years ago. How much you pay depends on whether you filed those taxes single, married jointly, or married but filing separately. Note that the rates listed here are per person. Then consider how those rates affect a married household.

Annual Income in 2020	Part B Premium Cost in 2022
< $91,000 (single, married filing separately, or married filing jointly)	$170.10 per month $2,041.20 per year (Increased by $259.20 per year)
$91,000 – $114,000 (single or married filing separately)	$238.10 per month $2,857.20 per year (Increased by $362.40 per year)
$91,000 – $409,000 (married filing jointly)	$544.30 per month $6,531.60 per year (Increased by $829.20 per year)
$114,000 – $142,000 (single or married filing separately)	$340.20 per month $4,082.40 per year (Increased by $518.40 per year)
$142,000 – $170,000 (single or married filing separately)	$442.30 per month $5,307.60 per year (Increased by $674.40 per year)
$170,000 – $500,000 (single or married filing separately)	$544.30 per month $6,531.60 per year (Increased by $829.20 per year)
> $409,000 (married filing jointly)	$578.30 per month $6,939.60 per year (Increased by $880.20 per year)
> $500,000 (single or married filing separately)	$578.30 per month $6,939.60 per year (Increased by $880.20 per year)

A Quick Overview of Alzheimer’s Disease

According to the Alzheimer’s Foundation, Alzheimer’s disease affects more than 6 million people in the United States and those numbers are expected to rise to 12.7 million by 2050.

Although the exact cause of the disease is unknown, the condition is believed to be related to a protein, amyloid, that can form “plaques” in the brain. Other proteins, like tau, can form “tangles”. You do not need to know the specific terms, only that certain proteins cluster in the brain and have been found in people with Alzheimer’s.

These are not the only possible contributors to Alzheimer’s disease. The condition can run in some families, suggesting a genetic cause. Other people may be at risk because of previous head trauma or heart disease that affects blood flow to the brain. Even lifestyle choices like diet, alcohol use, smoking, and exercise levels may factor in. The unfortunate news is that there is no cure for the disease … not yet.

The New Alzheimer’s Drug — Aduhelm

In July 2021, the FDA approved a new medication to treat Alzheimer’s disease. They did so under the accelerated approval pathway and there has been controversy ever since.

The medication is an antibody called aducanumab, brand name Aduhelm, and it works by breaking up amyloid plaque in the brain. The FDA used two clinical trials to make their decision. In both studies, the amount of amyloid plaque decreased with treatment. However, only one of the two studies showed benefit in terms of memory loss and function. That benefit was relatively small.

If you do not find that data convincing (only 1 in 2 studies showed a clinical benefit!), you’re not alone. The problem is that Aduhelm has serious side effects too. Since the medication has been approved, one woman has died from the treatment and three others have been hospitalized. A study has shown that as many as 40% of people have swelling in the brain because of the treatment and the swelling has been severe enough to cause symptoms 25% of the time.

Medicare Part B Drugs

You may be wondering what this has to do with your Medicare premiums.

Aduhelm is not cheap. Without insurance, the company that makes it, Biogen, set the retail cost at $56,000 per year per person. An analysis in Nature pointed out that even if only 5% of people with Alzheimer’s take the medication, that could cost the healthcare system $17 billion per year!

Medicare Part B covers injectable medications approved by the FDA. Medicare pays 80% and you pay 20%. Since Aduhelm is the only medication in its class to treat Alzheimer’s disease, it is likely to be covered (if certain criteria are met). That is going to cost Medicare a pretty penny.

To assure that there is enough revenue to cover the cost of the drug as well as the many other services you will need, Medicare increased how much you will pay into the system. That explains the larger than usual bump in Part B premiums this year.

Challenges to Rising Premiums

Let’s say that people were not too happy about those Medicare premiums! Things got even more heated when Biogen cut the retail cost of Aduhelm was cut by 50% to $28,000 this year. Not only that, in April 2022, CMS decided to restrict coverage of the drug to people who were involved in clinical trials. That significantly decreased the number of people who could be potentially covered. The justification for the high rates was gone.

With the price cut, Department of Health and Human Services Secretary Xavier Becerra has asked CMS to reassess the premium price hike. It is now being considered but if implemented, the price adjustments would be reflected in the 2023 Medicare premiums. That leaves you paying high premiums this year. It’s not fair.

Bottom Line

Making Medicare beneficiaries pay hundreds of extra dollars might make sense if most of them would at least benefit from it. That’s not the case here. Only a small percentage of them would qualify for treatment and those who do might not get the results they are looking for. It seems a bit steep (and reckless) to charge so much when the medication does not yet have enough data to show it does what it’s supposed to do and there are major risks and side effects.

 

Aducanumab (marketed as Aduhelm) Information. (2021). U.S. Food and Drug Administration. https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/aducanumab-marketed-aduhelm-information

CMS Finalizes Medicare Coverage Policy for Monoclonal Antibodies Directed Against Amyloid for the Treatment of Alzheimer’s Disease | CMS. (2022). CMS.gov. https://www.cms.gov/newsroom/press-releases/cms-finalizes-medicare-coverage-policy-monoclonal-antibodies-directed-against-amyloid-treatment

Mullard, A. (2021). Landmark Alzheimer’s drug approval confounds research community. Nature, 594(7863), 309–310. https://doi.org/10.1038/d41586-021-01546-2

Peripheral and Central Nervous System Drugs Advisory Committee Meeting. (2021). U.S. Food and Drug Administration. https://www.fda.gov/advisory-committees/advisory-committee-calendar/november-6-2020-meeting-peripheral-and-central-nervous-system-drugs-advisory-committee-meeting

Salloway, S., Chalkias, S., Barkhof, F., Burkett, P., Barakos, J., Purcell, D., Suhy, J., Forrestal, F., Tian, Y., Umans, K., Wang, G., Singhal, P., Budd Haeberlein, S., & Smirnakis, K. (2022). Amyloid-Related Imaging Abnormalities in 2 Phase 3 Studies Evaluating Aducanumab in Patients With Early Alzheimer Disease. JAMA Neurology, 79(1), 13. https://doi.org/10.1001/jamaneurol.2021.4161