The Veterans Health Administration will cover Eisai and Biogen‘s Alzheimer’s treatment Leqembi, the businesses announced Monday.
In a press release, drugmaker Eisai said veterans within the early stages of the disease who meet VHA criteria are eligible for coverage of Leqembi. The choice by VHA stands in contrast with Medicare, which has declined to cover the treatment except in very limited circumstances.
CNBC didn’t immediately hear back from VHA. A document on the agency’s website says veterans have to be seniors, sign a consent form, have undergone an MRI prior to now yr, and have PET scan or spinal tap test results which are consistent with Alzheimer’s disease, amongst other criteria.
The VHA, under the Department of Veterans Affairs, is the biggest health system within the country, providing look after veterans at nearly 1,300 facilities nationwide. The system serves 9 million veterans annually. Nearly 168,000 veterans had Alzheimer’s disease in 2022, in accordance with federal estimates.
The Food and Drug Administration approved Leqembi on an expedited basis in January. Nevertheless, Medicare is actually not covering the expensive treatment, which Eisai has priced at $26,500 per yr.
The insurance program for seniors will only cover treatments equivalent to Leqembi for participants in clinical trials right away. Eisai has already accomplished its trial.
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Medicare has agreed to supply broader coverage of Leqembi as soon because it receives full approval from the FDA. Eisai and Biogen expect the agency to make a call on full approval in July.
Leqembi slowed cognitive decline in individuals with early Alzheimer’s by 27% in a late-stage trial. The treatment also carries risks of brain swelling and bleeding.
Leqembi is run as an intravenous infusion twice monthly. It targets brain plaque related to the disease.
