Dosage & Administration Drug label Prior authorization Pharmacy Financial assistance

Leqembi

(lecanemab-irmb)

LEQEMBI 200 MG in 2 ML InjectionLEQEMBI 500 MG in 5 ML Injection

Dosage & administration

* Confirm the presence of amyloid beta pathology prior to initiating treatment.

* The recommended dosage is 10 mg/kg that must be diluted then administered as an intravenous infusion over approximately one hour, once every two weeks.

* Obtain a recent baseline brain MRI prior to initiating treatment.

* Obtain an MRI prior to the 5th, 7th, and 14th infusions. If radiographically observed ARIA occurs, treatment recommendations are based on type, severity, and presence of symptoms.

* Dilution in 250 mL of 0.9% Sodium Chloride Injection, USP, is required prior to administration.

* Administer as an intravenous infusion over approximately one hour via a terminal low-protein binding 0.2 micron in-line filter.

drug label

Leqembi prescribing information

Contact Medical Science Liaison Report Adverse Event

prior authorization

Leqembi prior authorization resources

Most recent Leqembi prior authorization forms

View By Payer

Verified: Sep 26, 2023Blue Cross Blue Shield of Michigan - Leqembi Prior Authorization Form (Medical Benefit)

Verified: Sep 21, 2023Aetna - Leqembi Prior Authorization Form

PDFComplete Letter of Medical Necessity

PDFCoverage Authorization Request

PDFCoverage Authorization Appeals

PDFRequest for Prescription Drug Coverage Exception Letter

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Benefits investigation

PDFLeqembi Eisai Patient Support Program Enrollment Form

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pharmacy

Leqembi preferred pharmacy

PDFPharmacy List

financial assistance

Leqembi financial assistance options

Co-pay savings program

commercial only

PDFLeqembi Eisai Patient Support Program Enrollment Form

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Overview

Reduce patient OOP costs for drug (and occasionally for drug administration/infusion costs or drug-related test costs)

Patient benefit

A portion (or all) of patient OOP (deductible, copay), typically up to monthly and/or annual max

Patient eligibility

Patient must enroll or activate (may permit HCPs to enroll on patient’s behalf for HCP-administered drugs)
Generally, must have commercial insurance (rarely, may permit uninsured patients to use)
May never be used with government insurance

How to sign up

Cards may be downloadable digital cards or hard copies
Some pharmacos offer debit cards with pre-loaded copay benefit
Typically, available through multiple channels (e.g., rep to HCP to patient; pharmacy to patient; patient via website, Hub live agent, or copay vendor (live agent or IVR); patient and HCP via Hub enrollment form)
Some HCP-administered product programs permit HCPs to enroll on a patient’s behalf through via Hub form

Bridge program

commercial only

PDFLeqembi Eisai Patient Support Program Enrollment Form

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Overview

Provide patient immediate access to therapy during an insurance delay (typically new starts; some may cover change in insurance)
Limited time/ fill (typically 7-30 days; some may offer additional fill for continued delay up to certain limit)

Patient benefit

100% free (outside of insurance)

Patient eligibility

HCP must enroll patient
May be limited to commercially insured patients (i.e., no government beneficiaries); some programs may allow government beneficiaries

How to sign up

Typically HCP assisted enrollment (via form)

Foundation programs

under insured

no insurance

goverment insurance

65+

PDFLeqembi Eisai Patient Support Program Enrollment Form

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Overview

Charitable 501(c)(3) organizations provide direct cost-sharing and other support (e.g., travel, counseling) through disease-state funds to indigent patients on first-come first-served basis
These organizations may receive financial contributions from drug manaufacturers for particular disease-state funds that cannot provide funds directly to patients - the foundation must be independent/unaligned

Patient benefit

Patients apply for grants that cover a portion (or all) of their out-of-pocket costs (deductibles and co-pays) until the grant is exhausted

Patient eligibility

Patients must apply and meet eligibility criteria including income level (typically a multiple of federal poverty line), specific diagnosis, insurance status, etc.

How to sign up

Patients submit proof of out-of-pocket drug costs to charities for reimbursement

patient education

Leqembi patient education

Getting started on Leqembi

To share resource; ask patient to:

1.Pull out phone

2.Open camera

3.Scan QR code with camera

4.Tap link

Patient toolkit

Learn More

Other resources

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Leqembi FAQs

How is the dosage of Leqembi?Leqembi is available in 2 dosages, including 100 mg/ml Injection 2 ml and 500 mg/5ml Injection 5 ml

What does Leqembi treat?Leqembi treats Alzheimer Disease

How Is Leqembi Administered?Leqembi is administered as a Injectable

FAQ Data Source

Leqembi

Dosage & administration

drug label

Leqembi prescribing information

prior authorization

Leqembi prior authorization resources

Most recent Leqembi prior authorization forms

Benefits investigation

pharmacy

Leqembi preferred pharmacy

financial assistance

Leqembi financial assistance options

Co-pay savings program

Bridge program

Foundation programs

patient education

Leqembi patient education

Getting started on Leqembi

Patient toolkit

Other resources

people also ask

Leqembi FAQs