Alzheimer’s drug gets FDA approval: Is Leqembi covered by Medicare?
The Food and Drug Administration has approved Leqembi, the first drug shown to slow down the progression of Alzheimer’s disease. Does Medicare cover it?
The Food and Drug Administration has given full approval to Leqembi, the first drug to show the capacity to slow cognitive decline in early Alzheimer’s patients.
Leqembi, which has the generic name lecanemab, does not cure or reverse Alzheimer’s. However, it may slow down the progression of the illness and give patients a better quality of life. Full approval demonstrates that the FDA believes that the medicine can help preserve memory and thinking.
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Is Leqembi covered by Medicare?
After the announcement of FDA approval of the drug, Medicare coverage for it will be expanded. Before the approval, Medicare only paid for Leqembi patients in certain clinical trials.
With the expanded coverage, a million or more Medicare beneficiaries who exhibit early signs of cognitive problems are possible candidates for the drug.
The federal Medicare health insurance program primarily serves adults who are 65 years old and above. More people who are in the early stages of Alzheimer’s will have access to the drug and be able to pay for it. The annual price of Leqembi set by its maker Eisai is $26,000, a price that many cannot afford without insurance.
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Conditions for Medicare coverage for Leqembi
To receive Medicare coverage, patients are required to find a health-care provider participating in a registry system that gathers real-world data on the drug’s benefits and risks.
Despite the possible access of more than a million Medicare patients, it is very likely that a smaller number of people will actually get their hands on Leqembi.
One reason for this is that the drug has some side effects such as bleeding or swelling in the brain, which could be life-threatening and could put off some potential users.
Also, the health care system in the country is not equipped at the moment to diagnose, heal, and monitor a big number of people suffering from Alzheimer’s.