What difference does it make? CED Approved Study or Registry = Layoffs

[anonymous]

Whether they will require an approved study for reimbursement or an ongoing registry, business won't get any better and only stands to reason there will be layoffs for certain.

 

[anonymous]

It will lie it affect how many are laid off. If there even is a CED and it is a study, it will mostly be limited to academic centers. A registry would be much less limiting…again, that’s IF there is a CED which we won’t know for certain until March/April. January is just the proposal.

 

[anonymous]

It will lie it affect how many are laid off. If there even is a CED and it is a study, it will mostly be limited to academic centers. A registry would be much less limiting…again, that’s IF there is a CED which we won’t know for certain until March/April. January is just the proposal.

Are you crazy? Serious, are you crazy??? Whatever CMS decides in January THAT IS IT!!!! Biogen does not have the advocacy to make any changes!!!

 

[anonymous]

Are you crazy? Serious, are you crazy??? Whatever CMS decides in January THAT IS IT!!!! Biogen does not have the advocacy to make any changes!!!

I agree. When the decision is announced on the 12th, I don't see anything Biogen will be able to do. It will be done. Final Decision.

 

[anonymous]

Never Getting Approved

 

[anonymous]

Are you crazy? Serious, are you crazy??? Whatever CMS decides in January THAT IS IT!!!! Biogen does not have the advocacy to make any changes!!!

Are YOU serious? YOU sound like an idiot. First of all, it’s not just for Biogen. Lilly, too. Also the nuclear medicine people are advocating like hell. Then there are the Alzheimers groups. Secondly, look at what happened with CAR-Ts. Theirs got changed after the proposal - removed the CED.

Moron.

 

[anonymous]

I agree. When the decision is announced on the 12th, I don't see anything Biogen will be able to do. It will be done. Final Decision.

idiot #2

 

[anonymous]

Never Getting Approved

Are there some insights you would like to share. lol

 

[anonymous]

Never Getting Approved

Never Getting Laid

 

[anonymous]

Are YOU serious? YOU sound like an idiot. First of all, it’s not just for Biogen. Lilly, too. Also the nuclear medicine people are advocating like hell. Then there are the Alzheimers groups. Secondly, look at what happened with CAR-Ts. Theirs got changed after the proposal - removed the CED.

Moron.

YOU are the moron. Unbelievable how you think this decision is going to be positive. Of course there will be some coverage but it is going to be one of the biggest nightmares in the world with a registry and other limitations. Stop kidding yourself. You must think this has been an incredible launch. The drug is dead in the water, especially when another drug is approved.

 

[anonymous]

Why would anyone think the outcome will be good? It won't be. Medicare has been denying everything. NCD will be extremely limiting.

 

[anonymous]

Why would anyone think the outcome will be good? It won't be. Medicare has been denying everything. NCD will be extremely limiting.

Sounds like someone who doesn’t have any infusions. We have not had one denied by Medicare FFS. It’s not like they can deny it right away, anyway, but the BIs are coming back clean and we have had a few claims paid.
Most Medicare advantage plans aren’t covering it, but that’s the decision of the payor, not Medicare. Once the NCD is determined, Medicare advantage plans must follow it. What makes me think there will be a semi-positive outcome (worst case is a registry) is that 1) medicare premiums were raised in anticipation of coverage 2) a CED for only a trial would limit rural and minority access (there’s a reason there’s a second IDEAs trial focused on minorities) so there would be some backlash on that 3) it’s not just the advocacy of Biogen, it’s Eli Lilly and every other company working on or planning on working on an AD drug, They want an accelerated approval and coverage precedent. Also, the nuclear medicine/imaging field is lobbying hard. 4) CMS already published a proposal to remove the NCD block for non-oncologic PET for 2022. It’s theorized that they will remove the sub NCD block for AB PET as well since they are planning to remove the “parent” NCD.

 

[anonymous]

Sounds like someone who doesn’t have any infusions. We have not had one denied by Medicare FFS. It’s not like they can deny it right away, anyway, but the BIs are coming back clean and we have had a few claims paid.
Most Medicare advantage plans aren’t covering it, but that’s the decision of the payor, not Medicare. Once the NCD is determined, Medicare advantage plans must follow it. What makes me think there will be a semi-positive outcome (worst case is a registry) is that 1) medicare premiums were raised in anticipation of coverage 2) a CED for only a trial would limit rural and minority access (there’s a reason there’s a second IDEAs trial focused on minorities) so there would be some backlash on that 3) it’s not just the advocacy of Biogen, it’s Eli Lilly and every other company working on or planning on working on an AD drug, They want an accelerated approval and coverage precedent. Also, the nuclear medicine/imaging field is lobbying hard. 4) CMS already published a proposal to remove the NCD block for non-oncologic PET for 2022. It’s theorized that they will remove the sub NCD block for AB PET as well since they are planning to remove the “parent” NCD.

You are working so hard at convincing yourself all is good. No one appreciates your sarcastic "Sounds like someone who doesn't have an infusions." Guess what? Your numbers still suck, so don't be so swift to toot your over-blown horn.

 

[anonymous]

Sounds like someone who doesn’t have any infusions. We have not had one denied by Medicare FFS. It’s not like they can deny it right away, anyway, but the BIs are coming back clean and we have had a few claims paid.
Most Medicare advantage plans aren’t covering it, but that’s the decision of the payor, not Medicare. Once the NCD is determined, Medicare advantage plans must follow it. What makes me think there will be a semi-positive outcome (worst case is a registry) is that 1) medicare premiums were raised in anticipation of coverage 2) a CED for only a trial would limit rural and minority access (there’s a reason there’s a second IDEAs trial focused on minorities) so there would be some backlash on that 3) it’s not just the advocacy of Biogen, it’s Eli Lilly and every other company working on or planning on working on an AD drug, They want an accelerated approval and coverage precedent. Also, the nuclear medicine/imaging field is lobbying hard. 4) CMS already published a proposal to remove the NCD block for non-oncologic PET for 2022. It’s theorized that they will remove the sub NCD block for AB PET as well since they are planning to remove the “parent” NCD.

Congratulations to you and both of your patients.

 

[anonymous]

GO.SOME PLACE.ELSE.

 

[anonymous]

You are working so hard at convincing yourself all is good. No one appreciates your sarcastic "Sounds like someone who doesn't have an infusions." Guess what? Your numbers still suck, so don't be so swift to toot your over-blown horn.

First of all, numbers sucking is all relative, here. Everyone sucks according to the leadership that created the IC payout. Idiots. Secondly, no one appreciates your inaccurate info that Medicare is denying claims, so quit posting it or deal with the sarcasm.