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Good News for Veterans: Lecanemab
Conditions for In/Exclusion

Coverage for Alzheimer’s Drug

 

Forbes.com reports that the Alzheimer’s medication lecanemab will be covered for the approximately 168,000 veterans with the disease, in order to provide “comprehensive, safe, and cost-effective pharmacy benefit for veterans.” Veterans must also meet the inclusion and exclusion criteria.

Inclusion criteria:

  • Age >65
  • An AD early stage diagnosis
  • ≤12 months prior cognition test
  • ≤12 months prior MRI
  • Results from analysis of cerebrospinal fluid consistent with AD
  • Results from amyloid PET scan consistent with AD

 

Exclusions include:

  • Mental health conditions potentially contributing to cognitive impairment
  • Transient ischemic attack, stroke, seizure within ≤12 months
  • MRI evidence of tumors, lesions, microhemorrhages, aneurysms
  • Some bleeding disorders
  • Above normal thyroid stimulating hormone range
  • Uncontrolled immunological disease

 

The drug costs about $26,500 per year and it has not yet been stated what the VHA will pay for it.

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