Keith Vossel, MD: Insurers setting plans for new Alzheimer’s drug, related scans

Dr. Keith Vossel

"A week after the Food and Drug Administration granted full, traditional approval to a new Alzheimer’s treatment, insurers are finalizing their plans to cover it as well as associated scans and diagnostic tests.

Medicare will cover most patients eligible for Leqembi, a new treatment developed by Eisai and Cambridge-based Biogen to help slow the progression of Alzheimer’s disease. The drug, which has modest benefits, has potentially serious side effects for some patients including brain swelling and bleeding.

Medicare told STAT that it would cover brain scans and genetic testing that will help screen for and monitor potential side effects. Medicare already covers one amyloid PET scan per lifetime, but the agency is reconsidering that policy and plans to release a new proposed policy “soon,’’ an agency spokesperson said.

Medicare was supposed to release a proposed policy for covering the PET scans in December, but delayed the decision until after the Centers for Medicare and Medicaid Services “has reviewed newly published evidence that is relevant to the proposed [coverage decision].’’

Other tests including MRIs to diagnose potential side effects, cerebrospinal fluid analysis, or other tests to detect the presence of amyloid plaques that the drug is designed to eliminate, and genetic testing for a certain mutation proven to increase the risk of adverse side effects are all coverable now, the spokesperson said.


Keith Vossel, a professor of neurology and the director of the Mary S. Easton Center for Alzheimer’s Research and Care at the University of California Los Angeles, concurred that it was easy to use, though he said the six-month reporting requirement seemed rigid.

Though UCLA isn’t offering Leqembi yet, he said there’s been interest along with news coverage of the approval.

“My e-mail inbox is getting flooded with physicians and patients interested in learning more about it,’’ Vossel said."

Read more in the Boston Globe's STAT News.