The Veterans Health Administration will take over Come on And BiogenTreatment for Alzheimer’s Lekambi, the company announced on Monday.
A statement from drug maker Eisai said veterans in the early stages of the disease who meet VHA criteria are eligible for Leqembi coverage. The VHA’s decision is in conflict with Medicare’s decision, which refused to cover treatment except in a very limited number of circumstances.
CNBC did not immediately receive a response from the VHA. A agency website document says veterans must be seniors, sign a consent form, have had an MRI in the past year, and have PET or spinal tap results that match Alzheimer’s disease, among other criteria.
VHA, administered by the Department of Veterans Affairs, is the largest healthcare system in the nation, providing care to veterans at nearly 1,300 facilities nationwide. The system serves 9 million veterans annually. Nearly 168,000 veterans will suffer from Alzheimer’s disease in 2022, according to federal estimates.
Food and Drug Administration approved by Lekambi fast track in January. However, Medicare essentially does not cover an expensive treatment that Eisai estimates at $26,500 a year.
The Senior Citizens Insurance Program will only cover treatments such as Leqembi for clinical trial participants. Eisai had already completed his test.
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Medicare has agreed to provide broader coverage for Leqembi once it receives full FDA approval. Eisai and Biogen Expect the agency to make a decision for full approval in July.
Lekambi slowed cognitive decline in people with early-stage Alzheimer’s by 27% during the late-stage study. Treatment also carries a risk of cerebral edema and bleeding.
Lekambi is administered intravenously twice a month. It targets brain plaques associated with the disease.