Leqembi IQLIK maintenance costs about $19,500 per year, and Medicare covers it for amyloid-positive early Alzheimer's when registry rules are met. Verify your dose, billing path, and eligibility before you commit to weekly shots. Leqembi IQLIK is a weekly subcutaneous form of lecanemab-irmb.
It uses a home autoinjector for people with mild cognitive impairment or mild dementia due to Alzheimer's. Eisai and Biogen announced in an Aug. 29, 2025 press release that FDA first cleared a 360-mg weekly maintenance dose after 18 months of IV lecanemab, as described in the FDA approval notice.
Medical information disclaimer: This article is for general educational purposes only and does not provide medical advice, diagnosis, or treatment. Always consult a physician or other qualified health professional about symptoms, medications, tests, or treatment decisions.
Table of Contents
- What changed for home use?
- What does IQLIK cost?
- How does Medicare cover it?
- Who qualifies and what safety checks apply?
- What should you verify before starting?
What changed for home use?
BioArctic and Eisai announced in a July 13, 2026 statement that FDA then cleared a 500-mg weekly starting dose using two 250-mg autoinjectors, as reported in the starting-dose announcement. That change allows some patients to start and continue treatment at home. It removes the need for biweekly infusion visits after the IV phase for those who qualify.
The practical difference is place and schedule. IV lecanemab requires clinic visits every two weeks. IQLIK uses a once-weekly shot at home after training and prescription review.
What does IQLIK cost?
Managed Healthcare Executive, citing Eisai, puts IQLIK maintenance at $375 to $385 per autoinjector, or about $19,500 per year. Initiation uses two autoinjectors per week, or $770 weekly. Eisai earlier set IV Leqembi list price at $26,500 per year for average-weight biweekly dosing.
Your bill depends on how the drug is billed. IV treatment runs through the medical benefit, while the autoinjector often runs through pharmacy coverage. Ask the clinic whether your plan bills IQLIK under Part B or Part D, and what deductible applies first.
How does Medicare cover it?
CMS states that Medicare covers Leqembi broadly after FDA traditional approval for patients in Medicare with mild cognitive impairment or mild dementia, confirmed amyloid, and a clinician reporting to a CMS registry, per the CMS coverage statement. Confirm that your diagnosis code, amyloid test result, and registry enrollment are documented. Medicare Advantage plans must cover the same benefit but may set different networks and prior-approval steps.
Original Medicare patients pay standard 20% Part B coinsurance after the deductible for IV Leqembi. That same CMS statement notes Medigap, secondary insurance, or Medicare Advantage terms materially change out-of-pocket cost. For pharmacy-billed IQLIK, CMS set annual Part D out-of-pocket drug spending at $2,000 in 2025 and $2,100 in 2026, with monthly payment smoothing, per the CMS payment announcement.
Who qualifies and what safety checks apply?
Treatment remains limited to amyloid-positive early disease. You need mild cognitive impairment or mild dementia plus a positive amyloid test. Later-stage dementia does not meet the labeled use.
Leqembi and IQLIK carry a boxed warning for amyloid-related imaging abnormalities, called ARIA. Risk runs higher in ApoE epsilon 4 homozygotes. Expect a baseline MRI plus scheduled follow-up MRIs, plus prompt scans for headache, confusion, dizziness, or vision change.
What should you verify before starting?
Call your plan with your exact dose and billing code in hand. Record the answers in writing with date and representative name.
- Weekly dose: 360 mg maintenance or 500 mg start as two 250-mg shots
- Billing path: medical versus pharmacy, deductible, coinsurance, and cap
- Eligibility file: amyloid result, disease stage, and CMS registry entry
- MRI plan: baseline date, follow-up dates, and after-hours contact for ARIA symptoms
- Assistance options: Eisai lists $0 copay up to $10,000 yearly for eligible commercially insured patients and free drug for eligible uninsured patients who meet financial criteria. Ask the prescriber to submit financial paperwork before your first fill.
