VA will offer coverage of Alzheimer’s drug after Medicare passes
Rachel Schilke
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The Veterans Health Administration said it will widely cover the expenses for a new Alzheimer’s drug after Medicare announced it would not.
Leqembi, a $26,500-per-year drug, was approved last month after going through the Food and Drug Administration’s accelerated pathway. Veterans living with early stages of Alzheimer’s can take the drug, manufactured by Eisai and Biogen, which can moderately slow cognitive decline by reducing the protein amyloid.
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The Centers for Medicare and Medicaid Services rejected the Alzheimer’s Association’s request for unrestricted coverage last month, stating it required further data before making a decision.
Results from the drug’s testing showed it slowed cognitive decline caused by Alzheimer’s by 27% compared to a placebo. It’s the first time results indicated that reducing amyloid can benefit patients.
Leqembi targets amyloid plaque built up in the brain. While reducing the buildup can be beneficial, it is not a cure for Alzheimer’s, per the Hill. The study also found that the drug produced serious side effects, including brain swelling and bleeding.
Without Medicare assistance, seniors would be unlikely to be able to afford the drug given the drug’s high prices and coverage restrictions. The FDA’s deadline for approval is July 6. If the agency gives the drug full approval, the Centers for Medicare and Medicaid Services would provide broader coverage benefits.
For now, Veterans Affairs will cover Leqembi, making it the first major insurer to pay for the drug.
Eisai and Biogen previously made an anti-amyloid drug, Aduhelm, which was initially nearly twice as expensive as Leqembi.
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Aduhelm lowered amyloid plaque but did not improve clinical outcomes in Alzheimer’s patients, so the drug’s development ceased in 2012.
Both Veterans Affairs and Medicare declined to cover Aduhelm over safety and efficacy concerns.