Medicare Spending on Newly Approved Alzheimer’s Drugs Leqembi and Kisunla Far Below Initial Projections

People on Medicare are not getting the recently approved Alzheimer’s medications Leqembi and Kisunla nearly as much as federal officials anticipated, STAT reported. Uptake has been so muted that Medicare is not forecasting significant spending on them in 2026 or 2027.

That outlook marks a dramatic shift from two years ago, when Medicare projected it would spend billions of dollars annually on Leqembi alone.

The lower-than-expected spending aligns with multiple challenges the drugs have faced since approval. Leqembi and Kisunla are intravenous medications that require a lot of imaging. The population of eligible patients is limited.

The drugs continue to have little meaningful benefits while carrying a risk of severe side effects like brain bleeding. These factors have contributed to slower adoption than planners once expected. Separately, doctors and patients report difficulties getting certain doses of estrogen patches.

U.S. Food and Drug Administration has not yet included any estrogen patches on its list of drug shortages. The FDA removed the black box warning from hormone replacement therapies late last year.

The estrogen patch is the most insured type of hormone replacement therapy. That form of therapy has been in short supply amid a boom in the therapy’s popularity. 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 group first started including estrogen patches on its shortage list in January. The dual developments illustrate ongoing access hurdles for both new specialty therapies and established treatments experiencing unexpected demand surges.