But Eisai has said its $26,500 annual list price for Leqembi is lower than the company's estimate of the $37,600 total value of the drug for each patient. Eisai developed Leqembi and conducted clinical trial of the drug, which is being manufactured by Biogen.CMS Administrator Chiquita Brooks-LaSur last week said that Medicare will cover Leqembi on the same day the treatment receives the greenlight from FDA.
Medicare, which operates independently from the FDA, decides whether to cover the cost of a drug based on its own determination of whether a treatment is "reasonable and necessary" for patients. "And it will increase the premiums of over 60 million seniors who receive Medicare whether they need to take this drug or not," Sanders wrote.
Leqembi received accelerated approval from the FDA in January. But Medicare severely limits coverage of Alzheimer's antibody drugs that are cleared under that expedited pathway.
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