On December 12, 2024, the Centers for Medicare & Medicaid Services (CMS) issued a directive requiring private insurers offering Medicare Advantage plans to cover Biogen Inc.'s amyotrophic lateral sclerosis (ALS) drug, Qalsody. This action by the U.S. agency follows documented instances where coverage for the drug had been denied.
Qalsody is a treatment for ALS, a progressive neurodegenerative disease with significant unmet medical needs. The CMS directive aims to ensure that eligible patients enrolled in Medicare Advantage plans have access to this important therapy, removing a key barrier to treatment.
This regulatory intervention is expected to positively impact the commercial uptake of Qalsody by broadening patient access and securing reimbursement. Increased coverage can lead to higher sales volumes for Biogen, contributing to the drug's overall market performance and addressing a critical need for ALS patients.
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