Medicare Spending on Alzheimer's Drugs Falls Far Short of Projections

Medicare uptake for Alzheimer's drugs Leqembi and Kisunla has been so muted that Medicare is not forecasting significant spending on these drugs in 2026 or 2027, despite projecting billions of dollars annually on Leqembi alone two years earlier. Both intravenous medications require complex administration and extensive imaging, face limited eligible patient populations, and carry risks of severe side effects like brain bleeding while offering little meaningful benefit.

Medicare Alzheimer's drug spending

• ▪Medicare uptake for Leqembi and Kisunla has been so muted that Medicare is not forecasting significant spending on these drugs in 2026 or 2027.
• ▪The lower-than-expected Medicare spending on Leqembi and Kisunla lines up with the challenges that the Alzheimer's drugs have faced since their approvals.
• ▪Two years before May 11, 2026, Medicare projected it would spend billions of dollars annually on Leqembi alone.

Leqembi uptake challenges

• ▪The population of patients eligible for Leqembi is limited.
• ▪Leqembi continues to have little meaningful benefits while carrying a risk of severe side effects like brain bleeding.
• ▪Leqembi is an intravenous medication that is not easy to administer and requires a lot of imaging.

Estrogen patch shortages

• ▪The estrogen patch has been in short supply amid a boom in hormone replacement therapy's popularity.
• ▪The U.S. Food and Drug Administration removed the black box warning from hormone replacement therapies late in 2025.
• ▪The American Society of Health-System Pharmacists first started including estrogen patches on its drug shortage list in January 2026.
• ▪The American Society of Health-System Pharmacists includes 14 brands or dosages of estrogen patches in its most current list of drugs in shortage.
• ▪The U.S. Food and Drug Administration has not yet included any estrogen patches on its list of drug shortages as of May 11, 2026.

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