The US Veterans Health Administration will pay for some beneficiaries to get a new Alzheimer’s disease drug from Eisai Co. and Biogen Inc., positive news for a treatment that Eisai expects to bring in billions of dollar in sales in the next few years.
(Bloomberg) — The US Veterans Health Administration will pay for some beneficiaries to get a new Alzheimer’s disease drug from Eisai Co. and Biogen Inc., positive news for a treatment that Eisai expects to bring in billions of dollar in sales in the next few years.
The VA added Leqembi, which received accelerated approval from the Food and Drug Administration in January, to its list of nonformulary drugs. Patients who want to take the medication would have to request it, receive prior approval and meet stringent inclusion criteria, according to the VA website.
The decision moves toward broader coverage of the controversial drug category. Tokyo-based Eisai praised the agency in a statement, saying the VA’s decision “shows its continued commitment to veterans living” with Alzheimer’s disease. The agency oversees care of more than 9 million veterans of the US military.
Biogen shares rose 0.9% at 3:40 p.m. in New York. Eisai’s depositary receipts were up 0.3%.
Slowing Disease
About 170,000 VA patients have Alzheimer’s dementia, according to an agency document, though it’s not clear how many meet the criteria for the drug. The VA didn’t immediately respond to a request for comment.
Leqembi is the first drug shown to slow the progress of Alzheimer’s, which robs patients of memory and other brain functions, and Eisai has said that it expects revenue from the product to reach $7.3 billion in 2030. The drug rids the brain of abnormal protein, called amyloid, that has been linked to the lethal disease.
Health officials tightly restricted payment for a similar drug, Biogen’s Aduhelm, after it received accelerated approval, saying data hadn’t sufficiently shown it was effective. The VA declined to cover Aduhelm.
The Medicare program that covers about 65 million US seniors and people with disabilities has held off on broader coverage for the class of new dementia drugs except in tightly limited clinical trials, saying more evidence is needed. It has indicated it will reimburse for drugs that target amyloid for Alzheimer’s if they show clear clinical benefit in trials and gain traditional approval from the FDA.
The FDA declined to give early approval to another amyloid-fighting drug, Eli Lilly & Co.’s donanemab, in January.
–With assistance from Angelica Peebles and Jeannie Baumann.
(Updates with additional context throughout)
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