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What we know about Arkansas insurance coverage for the new Alzheimer's treatment

Health plans covering state and public school employees will also not cover Leqembi.

ARKANSAS, USA — The Federal Drug Administration (FDA) approved the Alzheimer's treatment Leqembi in July. It's the first medicine of its kind and will be used to slow down the progression of Alzheimer's to improve patient's quality of life. 

State Rep. Julie Mayberry, who is also a co-chair of the Arkansas Alzheimer's Disease and Dementia Advisory Council said she received a letter from Arkansas Blue Cross and Blue Shield saying they will not be covering Leqembi. Health plans covering state and public school employees will also not be covering the drug.

"Hearing that the FDA has approved it, made me immediately ask, 'Is it going to be available to people in Arkansas?' We discovered that there are lots of obstacles," said Mayberry. "There is a high cost to the drug, it's about $27,000 a year. What Blue Cross and maybe some of the others are concerned about is that they might feel that it won't be as effective enough to justify the cost."

Director for the Reynolds Institute on Ageing at UAMS Jeanne Wei said even with some insurances not covering it, this is a step in the right direction for the future of Alzheimer's treatment drugs. 

"We can give hope to people. What more could we ask for? We certainly now have something that can partly remedy the situation," said Wei. "They can still do many things that they would have loved to do and continue to do. With a minimum of six months or more, they can go to weddings, drive to work, they can do important things."

According to Wei, a similar drug is set to be approved by the FDA around the end of the year. This new drug will be injectable, and more convenient.

"It's more effective than the one they've already approved," said Wei. "You only need to get it once a month, and from the data that they have shown it's almost completely cleared within six months." 

Mayberry hopes this next drug will change the minds of insurers. 

"There will be lots of Arkansans who might be denied the opportunity to participate in this type of medical protocol. The hope is that there is another medication that hopefully will be approved in December or January, that is similar but offers even more promise" said Mayberry.

Medicaid, Centene, and the U.S. Veterans Health Administration all plan to cover Leqembi. United Healthcare will cover the treatment as well in patients who meet critical criteria.

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