The first drug shown to slow Alzheimer’s disease, Leqembi, hit the U.S. market over a year ago, but sales have been slow, major hospital systems have taken time to start using it, and some insurers have rejected coverage. The drug, which is manufactured by Japan’s Eisai, targets a sticky brain protein called amyloid that is a key indicator of Alzheimer’s. While studies have shown that it can delay the progression of the disease by a few months in patients with mild symptoms, some experts believe the impact may be too subtle for patients to notice. Additionally, the drug can cause side effects such as brain swelling and bleeding, requiring regular brain scans for monitoring.
The FDA gave Leqembi full approval last summer for patients with early stages of Alzheimer’s, and Medicare covers the drug as well as the scans needed for diagnosis. However, hospitals and health systems have taken longer than expected to set up their systems for delivering the drug. For example, the Cedars-Sinai health system in Los Angeles started administering the drug in early March after months of planning. Similarly, the Mayo Clinic in Rochester, Minnesota, started using Leqembi in October, but only for patients within a 100-mile radius to quickly address any side effects. Health systems are still working to understand how coverage for the drug, infusions, and scans works to prevent patients from incurring high costs.
Despite coverage being available, some patients may still struggle to access the drug due to insurance denials or delays in starting treatment. For instance, some patients had to wait several months to receive the drug, leading to concerns about its efficacy as the disease progresses quickly. Doctors emphasize the need for quicker identification of patients and early treatment to maximize the drug’s benefits. While some patients have reported manageable treatment processes and improved short-term memory with Leqembi, challenges remain in accessing timely care for Alzheimer’s patients.
Looking ahead, the availability and access to Alzheimer’s treatments may improve over time. The FDA is reviewing another potential treatment, Eli Lilly and Co.’s donanemab, which targets amyloid protein. Additionally, Eisai is planning to seek approval for an injectable version of Leqembi, making it easier to use. Blood tests may also be developed to speed up the detection of amyloid. However, researchers acknowledge that there is still a long road ahead in understanding and treating Alzheimer’s disease, which is complex and likely requires combination treatments for effective management. Despite these challenges, the development of drugs like Leqembi offers hope for patients and families affected by the devastating disease.
