Payer PolicyActive
Leqembi (lecanemab®)
EVICORE-MEDICAL_DRUG-08AF70CD
EviCore by Evernorth
Effective: June 1, 2023
Updated: January 13, 2026
created · Dec 4, 2025
Policy Summary
Evicore finds Leqembi (lecanemab) not recommended for approval/coverage because clinical efficacy is insufficient and safety concerns were demonstrated, effectively excluding it. If requested, use would be limited to patients who meet the FDA‑approved indication and trial population (mild cognitive impairment or mild dementia) and applicable coverage/safety criteria, with documentation of disease stage required (no other specific tests listed).
Coverage Criteria Preview
Key requirements from the full policy
"Leqembi is indicated for the treatment of Alzheimer's disease."
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