Leqembi could cost Medicare $5 billion per year
The Alzheimer's drug Leqembi is seen in this undated handout image obtained by Reuters on Jan. 20, 2023.
The new Alzheimer's antibody treatment Leqembi could cost Medicare up to $5 billion per year, according to research published in a leading medical journal this week.
Medicare would spend about $2 billion per year if around 85,700 patients test positive for the disease and are treated with the Eisai and Biogen product Leqembi, according to the research published Thursday in JAMA Internal Medicine.
The program for seniors would spend $5 billion if around 216,500 patients become eligible for the breakthrough treatment, according to the study.
The authors said the estimated costs to Medicare are conservative and that spending on Leqembi might increase more than anticipated 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 other institutions.
Eisai and Biogen have priced the twice-monthly 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, according to the researchers.
The study assumed Medicare would cover 80% of the costs, with patients left to pay the remaining 20% in full or in part depending on whether they have supplemental insurance.
Patients could face an annual bill of about $6,600 per year depending on the state they live in and whether they have supplemental insurance, according to the study. Some lower-income people who qualify for Medicare and Medicaid would pay nothing out of pocket.
Source: CNBC
