A drug designed to slow Alzheimer’s has been deemed too expensive by a group of national health economists, setting the stage for more patient access barriers.
Known as lecanemab, the drug was proven to slow the loss of cognition in patients with early Alzheimer’s disease. But a health technology assessment group called the Institute for Clinical and Economic Review recently reported that lecanemab was not effective enough to justify its price.
ICER, as the group is known, calculated a health-benefit price of $8,900-$21,500 annually, somewhat less than the drug’s current list price of $26,500. For many patients and their caregivers, though, the difference in cognitive function may well be priceless.
About Value Assessments & Access
ICER assesses the quality and cost-effectiveness of medical interventions, and its decisions can influence coverage and access decisions at the health plan, state and national level.
The report is a blow for patients hoping to access the new drug. Medicare has already restricted access to lecanemab as well as to aducanumab, both innovative treatments for Alzheimer’s disease.
Jim Taylor is caregiver to his wife Geri, who participated in Phase 1 trials for aducanumab, another recent breakthrough Alzheimer’s drug. He said she “greatly benefited” from the treatment, which he said could extend the time patients could be independent. The idea that medications for Alzheimer’s are inaccessible to the Medicare patients who need them leaves Jim feeling “outraged.”
“Patients should be able to make a choice about their treatment,” he said.
Jay Reinstein, a patient who is seeking Medicare approval for lecanumab, called the medication “potentially life-changing.” He was disappointed in ICER’s conversation about the drug’s effectiveness and value. “It is so important that patients are part of these decision-making processes and that our perspectives are actually taken into consideration,” he said.
ICER’s report could embolden other health plans to limit access and perpetuate restrictive coverage approaches to other emerging drugs for Alzheimer’s.