© Reuters. FILE PHOTO: The Alzheimer’s drug LEQEMBI is seen on this undated handout picture obtained by Reuters on January 20, 2023. Eisai/Handout through REUTERS/File Photograph
By Julie Steenhuysen
(Reuters) -The U.S. Medicare well being plan mentioned on Thursday it could restrict reimbursement for Eisai Co (OTC:) Ltd and Biogen Inc (NASDAQ:)’s Alzheimer’s drug Leqembi to sufferers whose medical doctors take part in a well being company database ought to the drug win full approval, a transfer advocates say will hinder its use.
The choice marks the primary time that Medicare has required data-collection by a so-called registry for the supposed use of a drug that has been deemed secure and efficient by the U.S. Meals and Drug Administration.
Leqembi acquired accelerated approval from the FDA in January, based mostly on restricted proof suggesting it could gradual cognitive decline in early Alzheimer’s sufferers. A panel of FDA advisers will talk about whether or not Leqembi ought to obtain conventional approval subsequent week, and a choice may come by early July.
Medicare, the federal government well being plan for People 65 and over, presently pays for Leqembi provided that sufferers are enrolled in a scientific trial. The company mentioned the registry requirement would broaden entry to the drug.
It will require medical doctors to submit proof on how the drug works in routine follow, and gather info in an “easy-to-use” portal maintained by the Facilities for Medicare and Medicaid Companies (CMS) upon conventional approval.
The CMS choice would apply to all Alzheimer’s therapies that scale back a protein known as beta amyloid from the mind, together with Eli Lilly (NYSE:) and Co’s donanemab, which just lately reported optimistic outcomes from its late-stage trial.
“Till CMS publicizes the registry design and particulars, it’s obscure how a registry will influence affected person entry to Leqembi,” Eisai mentioned in an announcement. Traditionally, such packages have restricted entry to sufferers in underserved communities, the corporate added.
Lilly known as on CMS to revise its choice and urged the company to supply full Medicare protection for FDA-approved Alzheimer’s medicines, saying the transfer would set a precedent for all new medicines.
“We strongly imagine that mandating affected person enrollment in registries will proceed to pose pointless limitations and contradicts CMS’ promise of broad protection to all Medicare beneficiaries,” a Lilly spokesman mentioned in an announcement.
In April, Lilly mentioned it believed Medicare would again down from its registry requirement as extra proof emerged exhibiting that clearing amyloid mind plaques can assist sufferers.
Such “protection with proof growth” necessities are uncommon and traditionally utilized by Medicare to judge medical gadgets quite than medicine.
“We proceed to imagine that registry as a situation of protection is an pointless barrier,” the Alzheimer’s Affiliation mentioned in an announcement. The group mentioned it helps accumulating info on how such therapies work, however not as a requirement for protection of an FDA-approved drug.
Biogen’s shares have been 2.6% greater, whereas Eli Lilly was up 1.3%.
Duke College economist Dr. Mark McClellan, who has served each as FDA commissioner and a CMS administrator, mentioned it seems CMS is making an attempt to make the registry much less cumbersome, however that it should present extra particulars. “That should occur fairly shortly.”
To obtain Medicare protection, folks will should be identified with gentle cognitive impairment or early dementia brought on by Alzheimer’s and have a professional doctor taking part in a registry.
William Blair analyst Myles Minter didn’t see the registry requirement considerably limiting affected person entry. “We imagine that registries at specialist facilities the place Leqembi is prone to be initially administered won’t be a considerable hurdle.”
A CMS spokeswoman mentioned the preliminary registry can be administrated by the company ought to Leqembi acquire full approval and was hopeful different organizations would create extra registries to gather knowledge.