Medicare could save millions of dollars every year by changing the way they package Alzheimer's medication.

Alzheimer's affects roughly 5.8 million Americans, according to the Centers for Disease Control and Prevention. The progressive disease is the most common form of dementia and is associated with memory loss and cognitive decline in regions of the brain involved in thought, memory and language.

The leading theory for what causes the disease is an abnormal buildup of proteins in and around the brain cells, and in January 2023 the U.S. Food and Drug Administration approved the first drug that targeted these protein clumps.

The drug, called lecanemab—brand name Leqembi—became available for most Medicare patients with early signs of Alzheimer's disease in July 2023. However, new research from the University of California, Los Angeles (UCLA) has found that federal health insurance could be wasting up to $336 million every year due to discarded medication.

Image of a brain scan with medication in the foreground. UCLA research has found that Medicare could save hundreds of millions of dollars a year by changing the way Alzheimer's drugs are packaged. Image of a brain scan with medication in the foreground. UCLA research has found that Medicare could save hundreds of millions of dollars a year by changing the way Alzheimer's drugs are packaged. Ildar Imashev/Getty

The dosage of lecanemab required by a patient is dependent on their body weight. Today, the drug is only available in single-use 500 mg and 200 mg vials. So, for a patient weighing 143 pounds the prescribed dose would be 650 mg. In order to get the required dosage from existing vial sizes, patients would end up throwing away 50 mg of the leftover drug.

Under the Infrastructure Investment and Jobs Act of 2021, drug manufacturers are required to reimburse Medicare for product waste over 10 percent. However, study author Frank Zhou, a fourth-year medical student at the David Geffen School of Medicine at UCLA, said that lecanemab waste was likely to be nearer to 6 percent rendering current policy ineffective.

"Further policy changes are likely needed," Zhou said.

Aside from that, the team estimate that this waste could be reduced by 74 percent if a third vial size of 75 mg was introduced, without significantly harming the product quality or pricing.

"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," Zhou said.

"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."

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References

Zhou, F. F., Tseng, C.-H., Leng, M., Delarmente, B. A., Damberg, C. L., Sarkisian, C. A., & Mafi, J. N. (2024). Reducing Wasteful Spending on Discarded Lecanemab in the U.S. Medicare Program. JAMA Internal Medicine. https://doi.org/10.1001/jamainternmed.2024.5292

Julia Cave Arbanas et al, (2023) Estimated Annual Spending on Lecanemab and Its Ancillary Costs in the U.S. Medicare Program, JAMA Internal Medicine. DOI: 10.1001/jamainternmed.2023.1749

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