New Alzheimer’s Drug

The FDA recently decided to grant approval Leqembi, which marks the first time in two decades that a drug for Alzheimer's has received full approval. Clinical trials suggest that Leqembi, administered by IV infusions every two weeks, can slow decline for people with mild symptoms by five to eighteen months. The approval means that Medicare will cover Leqembi for eligible patients at 80% of the total $26,500 cost, leaving patients responsible for the remaining thousands of dollars in co-pays. Medicare Advantage plans will now have to decide if and how they want to cover the drug. Commercial plans will cover the drug with pre-approval and do a review of the site of the infusion, trying to push it to outpatient. The additional cost could lead to increased premiums for all beneficiaries, not just those taking the drug. 

A key question - how much cost will patients have to take on, how much will employers and insurers be willing to pay and if it works well, how will this drug be used in treatment delivery for newly diagnosed and those whose disease is more advanced? One issue that may emerge is disparity in use - will lower income or Medicaid beneficiaries have less access?