Physicians are not prescribing new Alzheimer’s drugs to people with Medicare as often as anticipated. Two years ago, the Centers for Medicare and Medicaid Services (CMS) projected that Medicare would be spending 3.5 billion dollars a year on Leqembi alone in 2025. Bob Herman reports for Stat News on the reasons the new Alzheimer’s drugs are not prescribed.
First, only a limited number of patients are eligible for these drugs. Patients on blood thinners cannot receive these drugs because of the high risk of a brain bleed. Even if you are not on a blood thinner, you must get a PET scan to ensure you are in the early stages of Alzheimer’s in order to qualify for coverage.
Both Leqembi and Kisunla are administered through IV infusions. They require patients to travel to a clinic to receive the infusions every few weeks. After beginning treatment, patients need MRIs to monitor for brain bleeds and brain swelling.
Moreover, benefits from these drugs are slim, while risks of serious side effects, including brain bleeding are real. Still Medicare pays a lot for these drugs. Because the US does not regulate drug prices, Leqembi costs $27,000 a year. Kisunla, the other new Alzheimer’s drug costs $32,000 a year.
At the moment, Leqembi and Kisunla make up about one percent of Medicare spending on physician-administered drugs in Traditional Medicare. In 2024, just 9,200 or so patients with Medicare received Leqembi or Kisunla. Medicare spent $95 million on these two drugs. In 2025, slightly more than twice as many patients received these drugs, and Medicare spent $213 million on them.
Here’s more from Just Care:
- Who should take Leqembi, an Alzheimer’s drug?
- Beware experimental Alzheimer’s drug trials
- Bernie Sanders blasts drug manufacturers for the “unconscionable” price of Alzheimer’s drug
- Six warning signs of dementia
- Vigorous exercise found to ward off dementia
