The Veterans Health Administration covers Eisai And biogenic‘s Alzheimer’s treatment Leqembi, the companies announced on Monday.
In a statement, drugmaker Eisai said veterans in the early stages of the disease who meet VHA criteria are eligible for Leqembi coverage. The VHA’s decision contrasts with Medicare, which has refused to cover treatment except in very limited circumstances.
CNBC did not immediately hear a response from VHA. A Document on the agency’s website says veterans must be seniors, sign a consent form, have had an MRI within the past year, and have PET scan or spinal tap test results consistent with Alzheimer’s disease, among other conditions.
The VHA, which reports to the Department of Veterans Affairs, is the nation’s largest health care system, serving veterans at nearly 1,300 facilities nationwide. The system serves 9 million veterans annually. According to federal estimates, nearly 168,000 veterans had Alzheimer’s disease in 2022.
The Food and Drug Administration accelerated approval of Leqembi in January. However, Medicare essentially doesn’t cover the expensive treatment, which Eisai has put at $26,500 a year.
The senior insurance program currently only covers treatments like Leqembi for participants in clinical trials. Eisai has already completed his process.
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Medicare has agreed to provide broader coverage of Leqembi once it receives full FDA approval. Eisai and Biogen expect the agency to make a decision on full approval in July.
Leqembi slowed cognitive decline by 27% in people with early-stage Alzheimer’s in a late-stage study. Treatment also carries the risk of brain swelling and bleeding.
Leqembi is given as an intravenous infusion twice a month. It targets brain plaques associated with the disease.
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