Leqembi (lecanemab) has a list price of about $26,500 per year for the intravenous version, which is given as an infusion every two weeks. A newer self-injectable form called Leqembi IQLIK is priced at $375 per autoinjector, also used every two weeks, bringing its annual list price to roughly $9,750. What you actually pay depends on your insurance, your Medicare coverage, and whether you qualify for financial assistance.
List Price vs. What You Actually Pay
The wholesale acquisition cost, or list price, is what hospitals and pharmacies pay before any discounts or insurance negotiations. For the IV infusion version of Leqembi, that figure is approximately $26,500 per year. The subcutaneous autoinjector version (Leqembi IQLIK) costs $375 per dose. Since both versions are given every two weeks, that works out to 26 doses per year, putting the autoinjector’s annual list price near $9,750.
These numbers represent the sticker price. Most patients don’t pay the full amount out of pocket because insurance, Medicare, or assistance programs cover a significant portion. But the list price matters because it determines your coinsurance and copay calculations.
Cost for Medicare Patients
Medicare Part B covers Leqembi after patients meet their annual Part B deductible. From there, you’re responsible for 20% coinsurance of the Medicare-approved amount. For the IV version, 20% of $26,500 works out to roughly $5,300 per year in coinsurance alone. For the autoinjector version, 20% of $9,750 comes to about $1,950 per year.
If you have a Medigap (Medicare Supplement) plan, it may cover some or all of that 20% coinsurance, potentially reducing your out-of-pocket cost to near zero depending on your plan type. Medicare Advantage plans set their own cost-sharing rules, so your costs could vary widely. It’s worth checking your specific plan’s coverage details before starting treatment.
Medicare does require certain conditions for coverage. CMS covers Leqembi under a framework called Coverage with Evidence Development, meaning your prescribing clinician must submit data to a CMS-approved registry at the start of treatment and every six months for up to two years. You also need a confirmed diagnosis of mild cognitive impairment due to Alzheimer’s or mild Alzheimer’s dementia, with evidence of amyloid plaques in the brain.
Costs Beyond the Drug Itself
The price of Leqembi is only part of the total cost of treatment. Before you can start, you need documented evidence of amyloid buildup in your brain, typically confirmed through a PET scan or a spinal fluid test. Amyloid PET scans can cost several thousand dollars, though Medicare provides conditional coverage for them. Your out-of-pocket share depends on your specific plan and whether you’ve met your deductible.
Once treatment begins, regular MRI scans are required to monitor for a side effect called ARIA, which involves brain swelling or small brain bleeds. The FDA recommends MRI scans before the 3rd, 5th, 7th, and 14th infusions, plus a baseline scan within one year before starting treatment. That means at least five MRIs in the first year of treatment alone. Brain MRIs typically cost between $1,000 and $5,000 at list price, though insurance usually covers the bulk of that. Even with coverage, copays for multiple scans add up.
If you’re receiving the IV infusion version rather than the self-injectable, you’ll also have infusion center fees for each biweekly visit. These facility and administration charges vary by location but represent an additional cost that the autoinjector version eliminates.
The Autoinjector Option Changes the Math
Eisai, the company behind Leqembi, introduced the subcutaneous autoinjector specifically to lower the overall cost of treatment. At $375 per dose compared to roughly $1,019 per IV infusion, the autoinjector cuts the drug cost by more than 60%. It also removes the need for infusion center visits, saving on facility fees and the time commitment of biweekly clinic appointments.
The autoinjector is self-administered at home after initial training from a healthcare provider. For patients and caregivers already managing the daily demands of early Alzheimer’s, fewer clinic visits can be a meaningful practical benefit on top of the cost savings.
Financial Assistance Options
Eisai offers patient support programs for people who need help affording Leqembi. These programs generally serve uninsured patients or those facing significant financial hardship, providing the medication at reduced cost or no cost for those who qualify. Eligibility is typically based on income and insurance status, though specific thresholds aren’t publicly listed in detail. Patients or caregivers can contact Eisai’s support line or visit the Leqembi website to check eligibility.
For commercially insured patients, copay assistance programs may be available to reduce out-of-pocket costs. These programs generally don’t apply to Medicare or Medicaid beneficiaries due to federal anti-kickback rules, so Medicare patients are limited to Medigap coverage or state pharmaceutical assistance programs for additional help.
Private Insurance Coverage
Commercial insurers have been adding Leqembi to their coverage policies, but access varies. Most require prior authorization, meaning your doctor must submit documentation proving you meet specific clinical criteria before the insurer approves the prescription. This typically includes confirming your diagnosis, demonstrating amyloid pathology, and showing that you’re in the early stages of the disease.
Your coinsurance or copay under a private plan depends on how the plan classifies the drug. Some plans treat it as a specialty medication with higher cost-sharing tiers. Others cover it under medical benefits similar to how Medicare Part B handles it. Checking with your insurer before beginning treatment gives you the clearest picture of what your share will be.