Payer PolicyActive
Leqembi™ (lecanemab-irmb)
EVICORE-MEDICAL_DRUG-8437617D
EviCore by Evernorth
Effective: May 1, 2024
Updated: January 13, 2026
created · Dec 4, 2025
Policy Summary
Leqembi (lecanemab‑irmb) is indicated for Alzheimer's disease but EviCore does not recommend approval/coverage due to insufficient evidence of clinically meaningful benefit and demonstrated safety concerns; treatment initiation is only supported for patients with mild cognitive impairment or mild dementia (the trial population) and initiation at earlier or later stages is not supported. This policy specifies no particular documentation, test results, or medical-record requirements.
Coverage Criteria Preview
Key requirements from the full policy
"There are no safety or effectiveness data on initiating treatment at earlier or later stages of the disease than were studied."
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