Eisai Plots A Meticulous Path To Medicare Coverage For Lecanemab
US Exec Ivan Cheung Expects ‘More Open Access’ To Drug
Executive Summary
Ivan Cheung, Eisai’s US CEO, explains the ‘question-by-question’ the company is taking to convince the Centers for Medicare and Medicaid Services that its Phase III Clarity AD results in Alzheimer’s offer the ‘high level of evidence’ needed for smooth reimbursement of lecanemab.
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Medicare Spending Forecast For Leqembi Reflects CMS Angst About Alzheimer’s Drug Costs
The agency’s projection that Medicare will spend $3.5bn on Leqembi in 2025 is nearly three times the level of sales that marketer Eisai is expecting for the drug in North and South America combined in its fiscal year 2026.
Leqembi’s FSS Pricing Meets ICER’s Cost-Effectiveness Threshold; VA Requiring Coverage With Evidence
Eisai/Biogen Alzheimer’s treatment isn’t actually on the VA formulary, but Leqembi’s Federal Supply Schedule price, coming in at just over $20,000 annually, could address spending concerns.
Leqembi Coverage By Veterans Affairs Department Sign Of Success For Eisai’s Payer Engagement Strategy
Alzheimer’s product is following a different playbook than Aduhlem, reflecting better data – and hard-earned lessons. Eisai estimates that 80-90% of veterans who are eligible for Leqembi treatment based on the FDA label would also fit the VA’s criteria.