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Oct 15, 2024

New Vial Size Could Save US Medicare Millions on Alzheimer's Breakthrough Drug Leqembi

Leqembi is available only in single-use 500 mg and 200 mg vials, and so substantial amounts of this medication get discarded when patient is prescribed lower amounts

A new study says a simple change in the presently available sizes of the breakthrough Alzheimer's drug Leqembi could save Medicare—the federal health insurance programme in the US for those over 65 years and older—thousands of millions of dollars each year. Around 6 per cent of Leqembi, also known as lecanemab, gets discarded because patients are mostly prescribed doses lower than the size of the drug’s single-use vials.
A recently published report in the journal JAMA Internal Medicine says the waste costs Medicare about $1,600 a patient every year, researchers estimated in a report published Oct. 14 in the journal JAMA Internal Medicine. The administered dosages are based on every patient's individual body weight. However, because the drug is currently available only in single-use 500 mg and 200 mg vials, substantial amounts of this expensive medication get discarded when the dose a patient is prescribed is lower than the amount contained in the vials.
According to researchers, making a 75-mg vial available alongside the two current options could save Medicare up to 74 per cent of the money lost from discarded Leqembi. “It is imperative to reduce spending on services that do not improve the health of patients, and this is a prime example of such, given that Medicare is paying for a drug only to literally throw part of it away,” lead researcher Dr. Frank Zhou, a fourth-year medical student at the David Geffen School of Medicine at UCLA wrote in the journal.

How does Leqembi work for Alzheimer's patients?

According to clinical trials, the drug, intended for those with mild cognitive impairment or dementia, has marginal net clinical benefit. Many previous studies suggested that the cost of Leqembi along with the ancillary costs like treatment for brain swelling linked to the medication, could cost Medicare $2 billion to $5 billion every year.
Zhou also said healthcare costs continue to increase - placing significant strain on the Medicare budget.
Medicare patients are prescribed Leqembi if they have been diagnosed with mild cognitive impairment or mild Alzheimer’s disease and their doctor agrees to participate in ongoing data gathering regarding the drug’s effectiveness. Previous estimates have held that Leqembi treatment could cost Medicare $2 billion to $5 billion a year, based on the number of people eligible for the drug.
According to experts, the medicine shows that taking lecanemab over 18 months slows the rate of cognitive decline. It is not yet known whether the medicine helps in other ways, like slowing the development of Alzheimer's in those without symptoms of memory loss.
The drug is administered as an IV infusion every two weeks. However, doctors say those who take lecanemab have side effects like dizziness, headache, visual changes, confusion, swelling or bleeding in the brain, brain shrinkage, and, rarely, death.
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