Budget impact of lecanemab for medicare beneficiaries with early Alzheimer’s disease in the United States: a subgroup analysis

In 2024, Alzheimer’s disease affected approximately 6.9 million Americans aged 65 and older. Current therapies include acetylcholinesterase inhibitors, N-methyl-D-aspartate receptor inhibitors, and monoclonal antibodies. With an economic burden surpassing $345 billion, $222 billion borne by Medicare and Medicaid, this study evaluates lecanemab’s budgetary impact for early AD, including subgroup analyses by gender and race. A budget impact model evaluated LECA for early Alzheimer’s disease, comparing scenarios with and without the therapy. Inputs included market share, costs, duration, and compliance. Gender and race subgroup analyses, annual costs, PMPM, PTMPM, and sensitivity analysis outcomes were assessed to explore parameter-driven variability comprehensively. Introducing LECA for over 3.5 million eligible early AD patients in the U.S. may generate a three-year budget impact of $4.1 billion for Medicare. Incremental PMPM savings were $1.4, and PTMPM savings reached $24.1. Subgroup analyses revealed no significant gender or racial differences in PMPM and PTMPM, with variability only in overall budget impact. Sensitivity analyses indicate that enhanced healthcare resource utilization, reduced disease severity, and improved cost-efficiency among males contribute to strengthening Medicare’s budget sustainability. Utilizing LECA as a treatment for early AD is expected to be cost saving with respect to Medicare budgets in the U.S.