Eli Lilly expects Medicare coverage for Alzheimer's drugs - Reuters
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An Eli Lilly (NYSE:LLY) executive said that the pharma is expecting the Centers for Medicare & Medicaid Services to change policy and cover Alzheimer's treatments that target amyloid plaque, Reuters reported.
If so, it would benefit not only Lilly, which plans to release late-stage data on Alzheimer's treatment donanemab in June, but also Biogen (NASDAQ:BIIB) and Eisai's (OTCPK:ESALF)(OTCPK:ESAIY) already marketed Leqembi (lecanemab).
"We believe that [Medicare] will provide what we would call outright coverage like they do for every other FDA-approved medication," Derek Asay, Lilly (LLY) senior vice president of government strategy and federal accounts, told the news service in an interview.
Current CMS policy is to cover drugs like Leqembi, which received accelerated approval in January, but only if a patient is in a clinical trial. Otherwise, a patient will have to pay for the treatment on their own. The wholesale price of Leqembi is $26K per year.
Asay noted that Lilly (LLY) will have enough evidence to convince CMS that donanemab deserves broader coverage.
In June, Leqembi will face a US FDA advisory panel meeting to weigh recommending full approval. If the committee does that, it could influence CMS to cover the therapy.