Payer PolicyActive
Aducanumab-avwa (Aduhelm™)
EVICORE-MEDICAL_DRUG-AC2D4991
EviCore by Evernorth
Effective: January 1, 2022
Updated: January 13, 2026
created · Dec 4, 2025
Policy Summary
Evicore does not recommend approval or coverage of aducanumab‑avwa (Aduhelm) due to insufficient evidence of clinically meaningful benefit and demonstrated safety concerns. If requested, use must be for the FDA‑approved indication (Alzheimer’s), initiated in patients with mild cognitive impairment or mild dementia as studied, and documented to meet specific coverage guidelines and applicable safety criteria.
Coverage Criteria Preview
Key requirements from the full policy
"In the absence of additional clinical trials, there is not enough information to support approval."
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