How much infusions of this new Alzheimer’s drug cost (with and without insurance) and how patients can lower the cost.
Leqembi is an intravenous (IV) infusion prescribed for early Alzheimer’s disease that belongs to the amyloid beta-directed monoclonal antibody drug class. It contains the active drug lecanemab-irmb and is used to slow the progression of Alzheimer’s disease in patients who have mild cognitive impairment or mild dementia — meaning those who are still in the early stages of dementia or who are experiencing some cognitive defects that do not significantly impair their daily lives.
On January 6, 2023, Leqembi received full approval from the US Food and Drug Administration through the Accelerated Approval pathway for the treatment of Alzheimer’s disease. It joined the new wave of medications that targets the fundamental pathophysiology of Alzheimer's disease and have received traditional approval, including Aduhelm (aducanumab). Leqembi works by reducing amyloid plaques in the brain which, in turn, slows down the progression of cognitive decline associated with Alzheimer’s disease.
Following its successful clinical trial and FDA approval, Local Infusion became the first center in Maine to administer Leqembi — and we are ready to offer it in all of our locations once a patient is referred by a clinician.
Below, we break down how much infusions of this new Alzheimer’s drug cost (with and without insurance), along with how patients and caregivers can lower the cost if they decide to proceed with this treatment option.
How much does Leqembi (lecanemab) cost?
Leqembi, which is produced by Eisai Inc and Biogen Inc., has a list price of $26,500 per year. However, the actual out-of-pocket amount each patient pays will vary depending on their individual insurance coverage. Be sure to ask about co-pay assistance programs through Eisai if cost is of concern — many patients will qualify for additional assistance and even $0 copay depending on eligibility.
How does insurance coverage impact drug pricing?
How much the patient pays (aka out-of-pocket costs) is ultimately a function of the insurance plan. Every plan is different and has different premiums, but there are a few concepts that are important to remember:
Eisai estimates that roughly 91% of patients will be covered through Medicare with Medigap (supplemental insurance), Medicare Advantage, Medicaid, or Commercial insurance, thus reducing their care costs to $0 or a few dollars per day. The remaining 9% of patients will be responsible for 20% of Leqembi costs as co-insurance under Medicare Part B, paying $26,500 per year (or roughly $14.50 per day).
Don’t have insurance or aren’t in-network with your infusion center? It may be possible to bill your insurance company for the medication costs out-of-network. If out-of-network benefits aren’t available, you may be able to be seen as a self-pay patient.
How does site of care impact the cost of Leqembi (lecanemab)?
The only decision a patient can make to influence the cost of their infusion is to decide where to receive treatment. Generally, there are three options within the healthcare system where a patient may receive prescription drug infusion therapy from a healthcare professional:
Hospital outpatient is where 50-60% of infusions take place nationally. The cost is generally ~2x what it costs in the home or office. Home infusion has received a lot of press recently, but according to the National Infusion Center Association, it tends to be 50% more expensive than a healthcare provider’s office. The office setting will be the most affordable care setting for patients who have received a referral from their physician for infusion therapy.
How can I lower the cost of Leqembi (lecanemab) infusions?
Eisai is in the process of establishing a Patient Assistance Program to provide Leqembi at no cost for eligible uninsured and underinsured patients who meet certain financial criteria.
How Local Infusion can help
At Local Infusion, each patient is paired 1:1 with a Guide who works with you to determine your out-of-pocket costs and what financial programs you're eligible for. Guides also handle everything related to prior authorization.
For questions regarding pricing and insurance, our team will work together to provide guidance on financial assistance support and help our patients minimize costs where possible.
Read more about Leqembi