Lawmakers questioning Medicare on Leqembi costs, coverage

Medicare will cover Alzheimer's disease treatment Leqembi, but lawmakers have questions on the agency's approach and the drug's high cost. 

In a June 10 letter to HHS Secretary Xavier Becerra, Sen. Bernie Sanders, chair of the Senate Health, Labor, Education and Pensions Committee, called Leqembi's $26,500 annual price tag "outrageously high." 

"As we grapple with the huge number of Americans who will be seeking medical treatment for Alzheimer's, we must develop policies now that prevent pharmaceutical companies from bankrupting Medicare and our entire healthcare system," Mr. Sanders said in a news release.

In the letter, Mr. Sanders asked Mr. Becerra if Medicare premiums will increase because of the drug's high list price. 

If 10 percent of Medicare beneficiaries diagnosed with Alzheimer's disease received Leqembi, the drug would cost the program $17.8 billion annually, according to KFF. 

Before the drug's full FDA approval on July 6, Medicare only covered Leqembi and similar treatments for patients enrolled in clinical trials. 

In a July 5 news release, Rep. Cathy McMorris Rodgers, House Energy and Commerce Committee chair, criticized the agency's approach to covering the drugs. 

"CMS should already be covering key Alzheimer's treatments that have been cleared under the FDA's accelerated approval pathway, which already meet the FDA's gold standard of safety and effectiveness," Ms. Rodgers said. 

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