15 Oct Wasted Alzheimer’s Drug Can Cost Medicare Billions Annually

MedicalResearch.com Interview with:

Frank F Zhou

Frank F. Zhou  |  he/him
MD Candidate, Class of 2025
David Geffen School of Medicine at UCLA

MedicalResearch.com: What is the background for this study? What is Lecanemab used for?  How is it given to patients?

Response: Lecanemab is a new infusion therapy for Alzheimer’s disease. Its dosing is based on each patient’s body weight (10 mg/kg every two weeks), but the drug is only available in 500 mg and 200 mg single-use vials, meaning that any leftover drug in vials must be thrown away. Given that lecanemab is expected to cost Medicare billions of dollars each year, we hypothesized that discarded drug could result in significant wasteful spending.

MedicalResearch.com: What are the main findings?

Response:  Overall, 5.8% of dispensed lecanemab is likely discarded, representing up to $336 million in annual wasteful spending for Medicare. However, simply adding a third 75 mg vial size could reduce wasteful spending by up to 74% with minimal to no impact on quality of care. 

MedicalResearch.com: What should readers take away from your report?

Response: Medicare is currently spending significant amounts of money on a costly medicine, only to throw it away. Simple policy changes could reduce this waste, including changing vial sizes, or developing new protocols to allow sharing vials between patients.

In addition, current legislation requires manufactures to reimburse Medicare for drug waste exceeding 10%, but this policy is ineffective if lecanemab is 5.8%, sounding the bell that a lower threshold may be needed.

Lastly, given that lecanemab is costly and associated with limited clinical benefits and significant safety risks, the question remains whether we should be paying for this treatment at all, a topic explored in an excellent accompanying editorial independently written by Nathan Stall and Kenneth Covinsky. 

MedicalResearch.com: What recommendations do you have for future research as a results of this study?

Response: Lecanemab remains a controversial therapy, especially as it was approved in the United States but not the in the European Union or United Kingdom. Further research should examine its uptake and impact to date in the United States, including who has been able to access the therapy so far, and the drug’s real-world clinical efficacy and adverse effects.  

Citation: Zhou FF, Tseng C, Leng M, et al. Reducing Wasteful Spending on Discarded Lecanemab in the US Medicare Program. JAMA Intern Med. Published online October 14, 2024. doi:10.1001/jamainternmed.2024.5292

https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2825069

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Last Updated on October 15, 2024 by Marie Benz MD FAAD