Adoption of Leqembi is even slower than expected.
EXTON, PA., February 22, 2024 — The 2023 announcement of newly approved disease-modifying therapy (DMT) Leqembi (lecanemab) for Alzheimer’s Disease (AD) sparked eager anticipation within both the medical community and among families nationwide. The debut of Aduhelm from Biogen in 2021 brought with it a wave of logistical, safety, and efficacy concerns, leading to the cessation of its promotion in early 2024. Learning from this, the marketers of Leqembi, Eisai and Biogen, opted for a more cautious strategy, refraining from overpromising on efficacy and acknowledging the logistical challenges inherent in testing and monitoring associated with the treatment.
Spherix Global Insight’s January update from their Launch Dynamix™: Leqembi in Alzheimer’s Disease (US) service sheds light on neurologists’ early reactions to Leqembi. Analysis from 75 high-prescribing U.S. neurologists reveals the potential reasons behind the even slower-than-expected adoption of Leqembi for treatment of early AD.
Six months after the full commercial launch of Leqembi, few surveyed neurologists consider Leqembi to be a significant medical advance over other historical AD treatments. Satisfaction with Leqembi is relatively low compared with Spherix’s neurology analog launch benchmarks; specifically, the average satisfaction rating is 15% lower than the typical rating for a new neurology market entrant at a similar post-launch timeframe. Perhaps related to that, less than half of neurologists surveyed are actively recommending Leqembi to patients. As one interviewed neurologist said:
“I present the facts. In the end, what I tell them is I am not enthusiastic about using the drug. I never tell patients that it’s wrong for them to choose Leqembi. I just tell them that I don’t believe that it’s as helpful as they might have heard about, read about or, what they’ve discussed with other friends or family.”
Despite the Center for Medicare and Medicaid’s (CMS) decision for Medicare to cover Leqembi, getting Medicare coverage for patients is also posing a challenge. On average, two-fifths of patients deemed eligible were not prescribed Leqembi because they could not obtain Medicare or other insurance approvals. For some patients who can obtain Medicare or private insurance coverage, the co-pays are reportedly too high.
Testing is required to verify and monitor the presence of beta-amyloid to prescribe Leqembi, given the therapy acts by lowering beta-amyloid in the brain. However, nearly half of the neurologists have had issues with conducting the right sort of amyloid testing to gain approval. Further, one-third of respondents have experienced issues with conducting the required monitoring for amyloid related imaging abnormalities (i.e., ARIA) – a risk associated with Leqembi and similar amyloid-targeting therapies. These experiences then become barriers in the minds of neurologists:
“ARIA is not to be taken lightly. Also, the frequency of monitoring, and tolerability for testing is low. Access to PET is low.”
Leqembi’s mode of administration, infusion at an infusion center, is yet another logistical challenge. Three-fifths of the patients being treated with Leqembi receive their infusions at an offsite infusion center that is unrelated to the neurologists’ practice.
Ultimately, six months into the launch of Leqembi, some neurologists are weighing the potential benefits of the new DMT against the challenges and concerns associated with prescribing it, finding that the balance may not always tip in favor of adoption. On the other hand, one-half of neurologists do believe that clearing beta-amyloid does slow the progression of AD. Addressing some of the logistical issues could make more neurologists willing to prescribe Leqembi. Finally, there is a significant segment of neurologists who are looking forward to Eli Lilly’s donanemab, another anti beta-amyloid treatment expected to be approved in Q1 2024. For all these reasons, Spherix will continue tracking neurologists’ attitudes and use of DMTs in AD well into the future.
Launch Dynamix™ is an independent service providing monthly benchmarking of newly launched products for the first eighteen months of commercial availability, augmented by a quarterly deep dive into promotional activity, barriers to uptake, and patient types gravitating to the launch brand.
About Spherix Global Insights
Spherix Global Insights is a leading provider of market research, business intelligence and advisory services to the global life sciences industry. The company’s unique service offerings are powered by deep therapeutic knowledge, the Spherix Network specialty physician panel, and commercially relevant analyses to enable strategic decision-making by our valued customers.
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Spherix Global Insights Contacts
Blaine Cloud, Ph.D., Neurology Franchise Head
Blaine.cloud@spherixglobalinsights.com
Alissa Algarin, MBA, Insights Director, Neurology
