Global Courant 2023-05-13 00:39:11
The Alzheimer’s drug Leqembi can be seen in this undated handout image obtained by Reuters on January 20, 2023.
Eisai | Reuters
New Alzheimer’s antibody treatment, Leqembi, could cost Medicare up to $5 billion a year, researchers say research published this week in a leading medical journal.
Medicare would spend about $2 billion a year if about 85,700 patients test positive for the disease and are treated with the Eisai And biogen product Leqembi, according to the study published Thursday in JAMA Internal Medicine.
The program for seniors would spend $5 billion if approximately 216,500 patients qualify for the breakthrough treatment, according to the study.
The authors said estimated costs for Medicare are conservative and that spending on Leqembi could increase more than expected depending on demand and other factors.
The researchers who conducted the JAMA study included physicians and public health and policy experts. They are affiliated with the University of California Los Angeles, the Rand Corporation, Harvard Medical School, and Beth Israel Deaconess Medical Center in Boston, among others.
Eisai and Biogen have priced the bimonthly antibody infusions at $26,500 per year.
There are also additional annual costs estimated at $7,300 per patient associated with neurologist visits, MRI tests and PET scans, administration of infusions and monitoring for and treatment of potential side effects, the researchers said.
The study assumed that Medicare would cover 80% of the cost, with patients paying all or part of the remaining 20%, depending on whether they had additional insurance.
Patients can face an annual bill of about $6,600 a year, according to the study, depending on the state they live in and whether they have additional insurance. Some lower-income people who qualify for Medicare and Medicaid wouldn’t pay anything out of pocket.
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The Alzheimer’s Association, which lobbies on behalf of patients living with the disease, estimates that Alzheimer’s and other dementias will cost $345 billion this year. Those costs could reach $1 trillion by 2050, according to the association.
“That’s the case without treatment. Prevention and treatment are the only way to reduce these costs over time,” Robert Egge, the association’s head of public policy, said in a statement.
“But it’s not the cost that should determine whether people have access to life-enhancing care — it’s the impact on people that matters,” Egge said. “Treatments in the early stages of Alzheimer’s disease may mean a better quality of life.”
Leqembi had a positive effect on patients with early-stage Alzheimer’s disease in clinical trial results published in January in the New England Journal of Medicine.
The expensive treatment is currently unavailable to the vast majority of patients because Medicare has severely limited antibody coverage.
Medicare has promised to provide broader coverage of Leqembi if the FDA grants full approval of the treatment in July. Leqembi received accelerated approval from the Food and Drug Administration in January.
The Alzheimer’s Association, members of Congress and attorneys general are urging that Medicare drop the restrictions and cover Leqembi in full.
The antibody treatment, which targets brain plaque associated with the disease, slowed cognitive decline by 27% in Eisai’s clinical trial.
There are currently no other drugs on the market that have demonstrated this level of effectiveness in slowing down Alzheimer’s disease. Eli Lilly’s donanemab demonstrated promising clinical trial results earlier this month. The company plans to file for full FDA approval this quarter.
Leqembi and donanemab both carry serious risks of brain swelling and bleeding.
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