Medicare Says It Expects To Spend $3.5 Billion In 2025 On Alzheimer’s Drug Leqembi, But This Is Unlikely

Forbes May 3, 2024
Joshua Cohen

Skepticism may be warranted when the Centers for Medicare and Medicaid Services’ Office of the Actuary says Medicare could spend as much as $3.5 billion on the Alzheimer’s disease drug Leqembi (lecanemab) in 2025. Even CMS’s projected cost to Medicare of $550 million for Leqembi in 2024 appears to be off base.

There were several explicitly stated assumptions made by CMS in its recent assessment of the cost of Medicare coverage of Leqembi. Perhaps the most conspicuous was presuming that a certain percentage of the eligible population of early Alzheimer’s disease patients would necessarily become actual users of the product, in spite of limited effectiveness and safety concerns around brain bleeding and swelling.

To arrive at the estimates, CMS considered...

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