Will US Medicare Fully Cover Alzheimer's Drugs? Eli Lilly Thinks Yes!

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  • Eli Lilly And Co LLY expects the U.S. Medicare health plan to loosen its grip on the coverage limits on new Alzheimer's drugs, as more data emerging in coming weeks show that clearing amyloid brain plaques can help patients.
  • Lilly plans to release results from a trial of its experimental amyloid-targeting drug donanemab before the end of June. More study data on Leqembi from Eisai Co Ltd ESALY/Biogen Inc BIIB is also expected in the coming months.
  • FDA granted accelerated approval to Leqembi, and a decision on full approval is due by July.
  • "We believe that they (Medicare) will provide what we would call outright coverage like they do for every other FDA-approved medication," Reuters reported citing Derek Asay's, Lilly's senior vice president of government strategy and federal accounts, interview. 
  • Also Read: Alzheimer's Association Launches Grassroots Level Lobbying For Medicare Coverage Of Alzheimer's Treatments.
  • The U.S. Centers for Medicare & Medicaid Services (CMS) did not immediately respond.
  • Medicare will only pay for anti-amyloid drugs approved under the FDA's accelerated review if patients are enrolled in a clinical trial.
  • Drugs in the class that receive traditional FDA approval – which may eventually include Leqembi and donanemab - would be covered if they participate in a registry that would track patients.
  • Asay said he believes Lilly and Eisai/Biogen would have ample evidence to address the agency's questions, which could open the door to broader coverage. Lilly has also participated in discussions with CMS.
  • Photo by Gerd Altmann from Pixabay
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