The Centers for Medicare and Medicaid Services announced on Thursday that, for Medicare to cover these expensive treatments, Medicare patients must be diagnosed with amyloid plaques on the brain and be treated by a physician who would be required to upload patient information into a federal database to monitor the real-world efficacy of the treatments.
Coverage for Leqembi falls under Medicare Part B, as the treatment is administered in a facility, with a 20% patient co-pay depending upon the patient's supplemental insurance, making the out-of-pocket costs for the treatment over $5,000 annually. The Alzheimer's Association announced that, although it applauds the FDA's approval of Leqembi and CMS's steps to cover the drug, Medicare needs to do more to ease access to life-altering care for those with this terminal illness. Of chief concern is the mandatory participation in the federal registry.
Source: Healthcare Press (healthcarepress.net)
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