Big vials of Alzheimer's drug could cost Medicare $336M
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Medicare could be throwing away as much as $336 million worth of a costly Alzheimer's drug each year because the size of vials is too big, UCLA researchers estimate.
Why it matters: The findings, published Monday in JAMA Internal Medicine, add to questions around the coverage of Leqembi, an infusable $26,500-a-year drug that's only available in single-use 500- and 200-milligram vials.
- Biogen and Eisai's treatment was the first shown to delay cognitive decline in early-stage Alzheimer's patients. But there are lingering questions about whether it provides a net benefit over other treatment options, and if it carries risks like brain swelling and bleeding.
What they found: While doses are calculated individually based on patient weight, the current vial sizes could lead to 5.8% of the dispensed drug being wasted, the UCLA researchers calculated.
- That comes out to $1,619 of unnecessary spending per patient per year.
- Discarded lecanemab could cost taxpayers between $133 million and $336 million annually, depending on how many patients use it, making it one of the three costliest Medicare drugs measured by wasted product.
- Researchers based the calculation on the number of Medicare beneficiaries who would have been potentially eligible for the drug in 2020.
Adding a new 75-milligram vial size could reduce the amount of the drug wasted by as much as 74%, the researchers said.
Flashback: During the pandemic, clinics wasted millions of COVID-19 vaccine doses because they were packaged in multi-dose vials that providers couldn't use up.
Reality check: The hundreds of millions that could be saved on Leqembi still pales in comparison to the billions Medicare is estimated to spend on the drug each year.
- Federal officials project it will cost Medicare $3.5 billion next year.
- "Modifying vial sizes to reduce discarded doses is penny wise, but ultimately widespread coverage by Medicare may be pound foolish" because of lecanemab's limited potential for benefit, JAMA Internal Medicine editors wrote in an accompanying essay also published Monday.
