Medicare Spending on New Alzheimer’s Drugs Falls Below Projections

Medicare is spending far less than expected on newly approved Alzheimer’s medications. A spokesperson for the Centers for Medicare and Medicaid Services told STAT that payments for the drugs are coming in well below forecasts. The agency is not forecasting significant spending on them in 2026 or 2027.

Uptake of the intravenous treatments has been muted. Two years ago, Medicare projected it would spend billions of dollars annually on one of the drugs alone. The lower spending aligns with several challenges the medications have faced since approval.

The drugs are not easy to administer and require substantial imaging. The population of eligible patients is limited. The treatments offer little meaningful benefit while carrying a risk of severe side effects such as brain bleeding, according to neurologists and Medicare experts who spoke with STAT.

Federal officials had anticipated much higher utilization when the drugs received approval. The intravenous medications must be given in clinical settings and involve regular monitoring with brain scans. These requirements have slowed adoption among Medicare beneficiaries diagnosed with early-stage Alzheimer’s disease.

The current outlook represents a change from earlier estimates. Medicare’s latest projections show no expectation of major expenditures on the drugs over the next two years. A spokesperson for the Centers for Medicare and Medicaid Services confirmed the revised spending forecast.

Neurologists have cited the logistical demands of the treatments as a barrier. Patients must travel to infusion centers for regular appointments. The required imaging adds further complexity and cost to the process. The pool of patients who qualify for the drugs is relatively small.

Only those with mild cognitive impairment or mild dementia due to Alzheimer’s meet the criteria. The medications’ modest clinical effects and safety concerns have also contributed to slower uptake.