How Much Does Leqembi Really Cost in 2026? A Complete Alzheimer’s Drug Price & Medicare Guide

“How Much Does Leqembi Really Cost in 2026? A Complete Alzheimer’s Drug Price & Medicare Guide”

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How Much Does Leqembi Really Cost in 2026?

A Complete Alzheimer’s Drug Price & Medicare Guide

Introduction

Leqembi (generic name lecanemab-irmb) is rapidly becoming one of the most high-profile Alzheimer’s therapies in the U.S. As patients and caregivers ask, “What will I actually pay?” this article walks through the 2026 cost, insurance / Medicare coverage, cost comparisons, and all the details you need to know to make informed decisions.

Latest Pricing & Cost Data (2025–2026)

Published List / Wholesale Prices

Note: These are list / wholesale numbers before discounts, rebates, and insurance adjustments.

Waste & Vial-Size Inefficiency

Because Leqembi is supplied in 200 mg and 500 mg single-use vials, weight-based dosing can lead to drug waste. A study estimated ~5.8% wastage in Medicare usage, and proposed that adding 75 mg or 250 mg vials could reduce waste significantly and save tens to hundreds of millions annually. Fierce Pharma

Out-of-Pocket & Insurance Costs for Patients (2026 Estimate)

In fact, one estimate puts the total cost of care per patient, including imaging, monitoring, and other medical services, at ~ US $ 82,500/year for Medicare/Medicaid patients. CBS News

Medicare & Coverage: What You Must Know

• Medicare now covers Leqembi under Original Medicare Part B for eligible patients. CMS+2Healthline+2

• Patients are charged 20% coinsurance of the Medicare-approved amount after Part B deductible. CMS+1

• Supplemental coverage (Medigap) or secondary insurance may absorb that 20% for many beneficiaries. Healthline

• The prescribing clinician must submit data to a CMS registry under a “coverage with evidence development” framework. CMS+1

• Some private insurers / commercial plans may require prior authorization and specific criteria for Leqembi coverage. Aetna

• In 2024, CMS expanded Medicare coverage to include another Alzheimer’s drug, Kisunla (donanemab-azbt) under similar rules. CMS+1

Comparison: Leqembi vs. Other Alzheimer’s / Neurology Drugs

Leqembi’s pricing is competitive in the new Alzheimer’s drug class, though cost and benefit balance remains controversial.

Recent Updates & 2025–2026 Developments

• In 2025, the FDA approved an injectable / subcutaneous maintenance version of Leqembi, branded Leqembi IQLIK, which may allow patients to shift from IV infusions to home injections. Reuters

• This version is priced at $19,500/year for a 360 mg autoinjector, according to announcements. Reuters

• Eisai’s cost-effectiveness evaluation was revisited via Japanese health authorities using a “special framework,” analyzing public caregiving and long-term care costs. Eisai

• Medicare is projecting rising per-member costs: $1.67 per member per month in 2024 → $4.67 PMPM in 2025 for the FFS program. Fierce Healthcare+1

• Given high drug cost and imaging burden, many observers argue Leqembi remains beyond reach for many Medicare beneficiaries with modest incomes (~$30,000). KFF

FAQs (20 Popular & High-Relevance)

1. Does Medicare cover Leqembi?
   Yes — under Original Medicare Part B for eligible patients if coverage criteria are met. CMS+2Healthline+2

2. What is the list price of Leqembi per year?
   $26,500 USD. Eisai+2Medical News Today+2

3. How much will I pay out-of-pocket with Medicare?
   Approximately 20% of the Medicare-approved cost, or ~$5,300/year (before supplemental coverage). NCOA+2Drugs.com+2

4. Does supplemental insurance (Medigap) reduce costs?
   Yes, many Medigap / secondary plans cover the 20% coinsurance. Healthline+1

5. How do Medicare Advantage plans treat Leqembi?
   It varies; many treat it like a Part B drug with 20% coinsurance until plan OOP limit. CMS+2Drugs.com+2

6. Are there patient assistance / copay programs?
   Yes — Eisai offers insurance & financial support programs. Leqembi

7. What other costs should patients expect?
   PET scans, MRI monitoring, biomarker testing, clinical visits. CBS News+2Fierce Pharma+2

8. Will Leqembi cost change in 2026?
   Yes — injectable version, rebates, and reimbursement pressures may alter effective cost.

9. What is Leqembi IQLIK?
   Subcutaneous / injectable maintenance version approved in 2025, priced ~$19,500/year. Reuters

10. Does private insurance cover Leqembi?
    It depends on plan formulary and approval policies. Drugs.com+1

11. Is Leqembi cost-effective?
    Debated — ICER suggests value-based price ~$8,900–$21,500 vs present list price. Wikipedia+2Eisai+2

12. How much will Medicare spend on Leqembi?
    ~$3.5 billion projected in 2025 across Medicare programs. STAT+2Global Alzheimer’s Platform Foundation+2

13. Why is Leqembi so expensive?
    R&D, biologic manufacturing, monitoring, limited competition. Northeastern Global News+1

14. Can Leqembi be wasted?
    Yes — vial sizes contribute to drug waste (~5.8%) resulting in excess cost. Fierce Pharma

15. How long do you have to stay on Leqembi?
    Treatment is ongoing; maintenance version helps reduce burden.

16. Who is eligible for Leqembi?
    Patients with mild Alzheimer’s / MCI and confirmed amyloid pathology. Healthline+2Leqembi+2

17. What are the risks / side effects?
    Brain swelling / microbleeds (ARIA), infusion reactions, monitoring risks.

18. When did Medicare start covering Leqembi?
    Traditional FDA approval in July 2023 enabled broader Medicare coverage. CMS+1

19. Can you pay cash / out-of-pocket entirely?
    Yes, but cost is extremely high unless subsidized / discounted.

20. How does Leqembi compare to Kisunla (donanemab)?
    Kisunla is another anti-amyloid drug now covered by Medicare; its pricing and dosing differ and may allow treatment cessation under certain conditions. CMS+2Being Patient+2

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• Leqembi 2026 Price & Medicare Breakdown

• What Will Leqembi Cost in the U.S. in 2026?

• Leqembi vs Donanemab: Cost & Coverage Comparison 2026

• Leqembi Monthly Cost, Insurance & Medicare Guide

• Leqembi Out-of-Pocket 2026: What You’ll Pay

• Alzheimer’s Treatment Costs 2026: Leqembi Edition

Summary & Key Takeaways

• Leqembi’s list price is $26,500/year in the U.S. (2025/2026) Eisai+2Medical News Today+2

• Medicare Part B covers 80% after deductible; patients typically pay ~20% (~$5,300) unless they have supplemental insurance. CMS+2Healthline+2

• Additional costs (scans, monitoring) can drastically increase total financial burden. CBS News+2Fierce Pharma+2

• The new injectable version (Leqembi IQLIK), approved 2025, may reduce cost and burden with a list price of $19,500/year. Reuters

• Cost vs benefit debate is ongoing — many health economists argue that effective value is lower than current price. CBS News+3Wikipedia+3Eisai+3

⏱️ Very Latest Updates You Should Add

1. FDA approves IV maintenance dosing every 4 weeks (2025)
   In January 2025, the FDA approved a supplemental Biologics License Application (sBLA) allowing lecanemab (Leqembi) to be given every 4 weeks (once monthly) in maintenance phase after the first 18 months of biweekly infusions. Eisai

   • This change gives patients and clinicians flexibility to shift from biweekly to monthly dosing. Medical Letter+1

   • Modeling based on Phase 2 and extension data suggests that less frequent dosing may maintain biomarker & clinical benefit. Eisai

2. Four-year efficacy & safety data from OLE (Open Label Extension)

   • At the Alzheimer’s Association International Conference (AAIC) 2025, Eisai will present 4-year efficacy / safety findings from continuous lecanemab treatment. Eisai Media Center+1

   • New published data show that over 3–4 years, lecanemab reduced cognitive decline (on the CDR-SB scale) by 1.75 points at 4 years relative to expected decline, and 1.01 points at 3 years compared to the Alzheimer’s Disease Neuroimaging Initiative (ADNI) cohort. Eisai+2Biogen Investors+2

   • Safety over 4 years remained consistent, with no new safety concerns and declining rates of ARIA after the first year. Eisai+1

3. U.S. market launch of subcutaneous version: LEQEMBI IQLIK

   • As of October 6, 2025, U.S. availability of LEQEMBI IQLIK™, a subcutaneous injection (prefilled autoinjector) for maintenance dosing, was launched. Biogen Investors

   • The companies also launched a “LEQEMBI Companion™” program to support patients — including training on injections, tracking tools, and nurse education. Biogen Investors

4. Real-world implementation & MRI scheduling data

   • In a presentation at AD/PD 2025, real-world U.S. data showed that, contrary to expectations, there were no major scheduling delays for MRI availability in patients prescribed Leqembi, alleviating a key concern about logistical bottlenecks. Pharmaceutical Technology

   • However, the patient demographics remain skewed: ~98.3% of Leqembi patients were in urban settings, and ~77.4% were white, suggesting disparities in access (e.g., rural or minority populations may be underrepresented). Pharmaceutical Technology

   • Also, many patients currently receiving Leqembi have been diagnosed at the mild Alzheimer’s stage, not earlier MCI, despite evidence that earlier treatment could yield more benefit. Pharmaceutical Technology

5. Feasibility in specialty memory clinics

   • A JAMA Neurology study recently showed that use of lecanemab in specialty memory clinics is feasible, and the frequency of serious adverse events (ARA, infusion reactions) was manageable. JAMA Network

   • This supports that, in expert centers, infrastructure can support administration without excessive harm.

6. Regulatory / Coverage developments & coding

   • The CMS National Coverage Determination (NCD) 200.3 covers monoclonal antibodies against amyloid under “Coverage with Evidence Development (CED)” when furnished per criteria. CMS+2CMS+2

   • CMS recently updated its coverage with evidence development (CED) guidance (August 2024) clarifying data submission, usage, and registry requirements. CMS

   • Medicare claims must use HCPCS code J0174 for lecanemab after July 6, 2023 (and other coding/delivery rules per CMS CR). CMS+1

   • Also, 2024 Medicare bid documents estimate per-member-per-month (PMPM) costs: ~$1.62 PMPM in 2024, rising to ~$4.56 PMPM. CMS

   • Additionally, CMS removed the National Coverage Determination (NCD) for beta-amyloid PET imaging, ending automatic “coverage with evidence development” for that imaging; now coverage is left to local Medicare Administrative Contractors (MACs). CMS+1

7. Global / regulatory adoption & EU approval

   • In the European Union, Leqembi has received market authorization (April 2025) for early Alzheimer’s disease in eligible patients. European Medicines Agency (EMA)+1

   • The EU decision is notable because it marks Leqembi as the first therapy targeting Alzheimer’s disease pathology (amyloid) authorized across all 27 EU member states. Eisai

8. Early treatment outcomes in specialty settings

   • In a neurology practice cohort over first 9 months of lecanemab treatment, cognitive decline was modest, roughly aligning with outcomes from the Phase 3 CLARITY-AD trial (e.g., slight increase in CDR score over 9 months). NeurologyLive