NEW ORLEANS — A breakthrough Alzheimer’s drug that was recently FDA approved, is just weeks away from being available to patients in Southeast Louisiana, but now there is new concern that some people will not be able to afford the medication.
Since early July, announcement of the new medication to slow the progression of Alzheimer's disease, has been giving doctors great hope.
“It's been over 30 years since we've had a new drug fully approved for Alzheimer's disease. I think this is the Kitty Hawk moment for Alzheimer's disease,” said Dr. Demetrius Maraganore, Tulane’s Chief of Neurology.
Bonnie Farmer Hay of West Monroe also has hope. Her dad was only 48 when he was diagnosed with Alzheimer's.
“To know that there's something that the, just in case in the back of my mind, you know, to know that's there. So, it helps,” said Hay, 46.
Medicare agreed to cover LEQEMBI. The co-pay for the $26,000 drug would be around $5,000, but not all private insurance for younger people have agreed yet to cover the FDA approved drug.
“Ten percent of people will not be able to get this treatment. and these are really the people who need it the most. We expect them to live a longer time with Alzheimer's,” Dr. Maraganore said about younger patients.
So we contacted Blue Cross Blue Shield of Louisiana, the largest private insurer in the state. A company spokeswomen said they consider coverage based on FDA approvals, and they are evaluating the new science to determine policy.
"Blue Cross and Blue Shield of Louisiana considers coverage for medications based on their U.S. Food and Drug Administration (FDA)-approved label," BCBS Vice President Cindy Wakefield said. "Our clinical team members are currently evaluating the science behind the FDA’s recent announcements on drugs to treat Alzheimer’s to determine our coverage policies. We expect to make a decision in the near future."
A decision will come in the near future. Doctors in New Orleans expect start using the drug Oct. 1.
When asked, if he thinks the drug is still experimental, Dr. Maraganore replied, “No. I think that this drug is ready for prime time. I'm prepared to prescribe it to our patients here in New Orleans and Louisiana.”
He says it's true, doctors and insurance companies will gain more knowledge when the drug is used in patients outside of clinical trials, but with Alzheimer’s disease, time is of the essence.
“That's obviously unfortunate that these people are effectively being discriminated against on the bases of their age, and the insurance that they have. And so we can expect that their will be a lot of lobbying on behalf of these patients,” he predicted.
The drug is for people with mild symptoms of Alzheimer’s. Patients also have to have a test to show they have the chemical signs of the disease.
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