Change in Alzheimer's Drug Vial Size Could Be Big Money-Saver for Medicare

October 14, 2024
Dennis Thompson HealthDay Reporter

A simple tweak in available vial sizes of the breakthrough Alzheimer’s drug Leqembi could save Medicare hundreds of millions of dollars each year, a new analysis claims.

About 6% of Leqembi (lecanemab) is discarded because patients are frequently prescribed doses lower than the size of the drug’s single-use vials.

This waste costs Medicare about $1,600 a patient every year, researchers estimated in a report published Oct. 14 in the journal JAMA Internal Medicine.

Making a 75-milligram vial available alongside the two current options of 200 milligrams and 500 milligrams could save Medicare up to 74% of the money lost from discarded Leqembi -- as much as $336 million a year.

“It is imperative to reduce spending on services that do not improve the health of patients, and this is a prime example of such, given that Medicare is paying for a drug only to literally throw part of it away,” said lead researcher Frank Zhou, a fourth-year medical student at the David Geffen School of Medicine at UCLA.

Medicare patients can be prescribed Leqembi if they’ve been diagnosed with mild cognitive impairment or mild Alzheimer’s disease and their doctor agrees to participating in ongoing data gathering regarding the drug’s effectiveness.

Prior estimates have held that Leqembi treatment could cost Medicare $2 billion to $5 billion a year, based on the number of people eligible for the drug.

Leqembi is administered based on a person’s body weight. For this study, researchers estimated how many Medicare patients are available to receive Leqembi, then calculated each person’s estimated dose.

The results showed that a lot of the drug is thrown out to make a person’s recommended dose match the vial sizes available to doctors.

For example, a 165-pound patient would be prescribed a 650-milligram dose, researchers said.

Doctors would draw that amount from one 500-milligram and one 200-milligram vial, and the remaining 50 milligrams of drug would be tossed out, researchers said.

That amounts to an estimated $133 million to $336 million worth of Leqembi thrown away every year, researchers said.

In essence, the discarded Leqembi from 16 patients could provide enough medication for an additional person, researchers found.

Adding a third 75-milligram vial could reduce that waste by 74% without harming quality of care or causing a drug price increase, the team concluded.

This sort of analysis could be helpful for many other drugs covered by Medicare, researchers noted.

“There are significant opportunities for savings even with this single drug, implying that even greater savings could be achieved if our proposed solutions were applied to other infused therapies,” Zhou said in a UCLA news release.

More information

The Mayo Clinic has more about Leqembi.

SOURCE: UCLA, news release, Oct. 14, 2024

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