Average annual per-person payments from all sources for health care and long-term care, traditional Medicare beneficiaries age 65+ WITH Alzheimer's or other dementias
Measured
US-national
46,141 USD per person per year (2025 dollars)
Who this covers: Traditional (fee-for-service) Medicare beneficiaries age 65+ with dementia
Inflated to 2025 dollars. Unadjusted for age/sex. Comparison group without dementia: $15,499. Includes community-dwelling and residential-care beneficiaries.
Source: Alzheimer's Association, 2026 Alzheimer's Disease Facts and Figures (Table 16; unpublished Medicare Current Beneficiary Survey 2018 data) · 2018
Average annual per-person payments from all sources, traditional Medicare beneficiaries age 65+ WITHOUT Alzheimer's or other dementias
Measured
US-national
15,499 USD per person per year (2025 dollars)
Who this covers: Traditional Medicare beneficiaries age 65+ without dementia
Inflated to 2025 dollars.
Source: Alzheimer's Association, 2026 Alzheimer's Disease Facts and Figures (Table 16) · 2018
Average annual per-person Medicare payments, traditional Medicare beneficiaries age 65+ with Alzheimer's or other dementias
Measured
US-national
23,231 USD per person per year (2025 dollars)
Who this covers: Traditional Medicare beneficiaries age 65+ with dementia
In 2025 dollars. Without dementia: $8,371.
Source: Alzheimer's Association, 2026 Alzheimer's Disease Facts and Figures (Table 16) · 2018
Average annual per-person Medicaid payments, traditional Medicare beneficiaries age 65+ with Alzheimer's or other dementias
Measured
US-national
7,158 USD per person per year (2025 dollars)
Who this covers: Traditional Medicare beneficiaries age 65+ with dementia
In 2025 dollars. Without dementia: $322.
Source: Alzheimer's Association, 2026 Alzheimer's Disease Facts and Figures (Table 16) · 2018
Average annual per-person private insurance payments, traditional Medicare beneficiaries age 65+ with dementia
Measured
US-national
1,622 USD per person per year (2025 dollars)
Who this covers: Traditional Medicare beneficiaries age 65+ with dementia
In 2025 dollars. HMO $2,063; uncompensated $203; other payer $987 for the dementia group.
Source: Alzheimer's Association, 2026 Alzheimer's Disease Facts and Figures (Table 16) · 2018
Discounted lifetime total cost of care per person with dementia from diagnosis (mean age 83) to death, including informal care, out-of-pocket, Medicaid and Medicare
Modelled estimate
US-national
321,780 USD (2015 dollars)
Who this covers: Simulated representative US incident dementia cases
Families incurred 70% ($225,140), Medicaid 14% ($44,090), Medicare 16% ($52,540). Incremental cost vs no dementia $184,500 (86% borne by families). Annual cost peaked at $89,000. Facts and Figures 2026 restates as $417,263 in 2025 dollars.
Source: Jutkowitz E et al. Societal and Family Lifetime Cost of Dementia. J Am Geriatr Soc 2017; doi:10.1111/jgs.15043 (PMID 28815557) · 2015
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Annual mean direct medical cost, cognitively normal (excludes long-term care and indirect costs)
Measured
US-national
6,042 USD per person per year
Who this covers: Olmsted County MN residents age 70-89 (Mayo Clinic Study of Aging)
Single-county population; dollar year not stated in abstract (publication 2015).
Source: Leibson CL et al. Direct medical costs and source of cost differences across the spectrum of cognitive decline. Alzheimers Dement 2015; doi:10.1016/j.jalz.2015.01.007 (PMID 25858682) · 2015
Annual mean direct medical cost, mild cognitive impairment (excludes long-term care and indirect costs)
Measured
US-national
6,784 USD per person per year
Who this covers: Olmsted County MN residents age 70-89 (Mayo Clinic Study of Aging)
Difference from cognitively normal not statistically significant.
Source: Leibson CL et al. Alzheimers Dement 2015 (PMID 25858682) · 2015
Annual mean direct medical cost, newly discovered dementia (excludes long-term care and indirect costs)
Measured
US-national
9,431 USD per person per year
Who this covers: Olmsted County MN residents age 70-89 (Mayo Clinic Study of Aging)
Source: Leibson CL et al. Alzheimers Dement 2015 (PMID 25858682) · 2015
Annual mean direct medical cost, prevalent (established) dementia (excludes long-term care and indirect costs)
Measured
US-national
11,678 USD per person per year
Who this covers: Olmsted County MN residents age 70-89 (Mayo Clinic Study of Aging)
Hospital inpatient costs were 70% of total for prevalent dementia.
Source: Leibson CL et al. Alzheimers Dement 2015 (PMID 25858682) · 2015
Traditional Medicare inpatient spending in the quarter of dementia diagnosis, persons diagnosed at MILD stage
Modelled estimate
US-national
8,491 USD per quarter
Who this covers: HRS respondents >70 with claims-based incident dementia diagnosis 2000-2016, severity modelled from ADAMS CDR
Rose from $3,192 the quarter before (+166%). Outpatient spending in quarter of diagnosis, mild stage: $4,498. Dollar year and full-year totals not in the source text we have.
Source: Xu S et al. Association of Dementia Severity at Diagnosis With Health Care Utilization and Costs Around the Time of Incident Diagnosis. Innov Aging 2025; doi:10.1093/geroni/igaf005 (PMID 40098605) · 2016
Traditional Medicare inpatient spending in the quarter of dementia diagnosis, persons diagnosed at MODERATE stage
Modelled estimate
US-national
8,831 USD per quarter
Who this covers: HRS respondents >70 with incident dementia diagnosis 2000-2016
From $2,534 the quarter before (+248%). Outpatient: $2,028 to $3,979 (+96%).
Source: Xu S et al. Innov Aging 2025 (PMID 40098605) · 2016
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Out-of-pocket payments for people age 65+ with Alzheimer's or other dementias
Modelled estimate
US-national
103 billion USD (2026 dollars)
Who this covers: Americans age 65+ with Alzheimer's or other dementias
25% of $409B total.
Source: Alzheimer's Association, 2026 Alzheimer's Disease Facts and Figures (Figure 15) · 2026
Out-of-pocket share of total payments for people with Alzheimer's or other dementias
Modelled estimate
US-national
25 percent
Who this covers: Americans age 65+ with Alzheimer's or other dementias
Source: Alzheimer's Association, 2026 Alzheimer's Disease Facts and Figures (Figure 15) · 2026
Average annual per-person out-of-pocket payments, traditional Medicare beneficiaries age 65+ with Alzheimer's or other dementias
Measured
US-national
10,877 USD per person per year (2025 dollars)
Who this covers: Traditional Medicare beneficiaries age 65+ with dementia
In 2025 dollars. Includes Medicare/other-insurance deductibles, copays, premiums and uncovered services. Without dementia: $2,674.
Source: Alzheimer's Association, 2026 Alzheimer's Disease Facts and Figures (Table 16) · 2018
Average annual per-person out-of-pocket payments, traditional Medicare beneficiaries age 65+ WITHOUT dementia
Measured
US-national
2,674 USD per person per year (2025 dollars)
Who this covers: Traditional Medicare beneficiaries age 65+ without dementia
In 2025 dollars.
Source: Alzheimer's Association, 2026 Alzheimer's Disease Facts and Figures (Table 16) · 2018
Share of annual (individual plus spouse/partner) income spent on out-of-pocket health care by people with Alzheimer's dementia, excluding nursing home and informal care
Measured
US-national
12 percent of income
Who this covers: People with Alzheimer's dementia
Comparison: 7% for people without Alzheimer's dementia.
Source: Alzheimer's Association, 2026 Alzheimer's Disease Facts and Figures (Use and Costs section, citing ref. 920) · 2026
Median annual out-of-pocket health care cost among people with moderate or severe dementia who had any expenditures
Measured
US-national
2,853 USD (2023 dollars)
Who this covers: People with moderate or severe dementia with any OOP expenditure
$3,010 in 2025 dollars. 71% of moderate and 80% of severe dementia had OOP costs in prior year; 21% of severe dementia had OOP costs >40% of post-subsistence income; 12% fell below federal poverty level after OOP costs.
Source: Alzheimer's Association, 2026 Alzheimer's Disease Facts and Figures (Use and Costs section, citing ref. 921) · 2023
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National median annual cost of a private room in a nursing home
Measured
US-national
129,575 USD per year
Who this covers: US nursing home residents (all causes)
$355/day; $10,798/month. Up 1% from 2024. Not dementia-specific.
Source: CareScout (Genworth) Cost of Care Survey 2025 · 2025
National median annual cost of a semi-private room in a nursing home
Measured
US-national
114,975 USD per year
Who this covers: US nursing home residents (all causes)
$315/day; $9,581/month; up 2% from 2024 ($9,277/month).
Source: CareScout (Genworth) Cost of Care Survey 2025 · 2025
National median annual cost of an assisted living community
Measured
US-national
74,400 USD per year
Who this covers: US assisted living residents (all causes)
$6,200/month, up 5% from $5,900 in 2024. Memory-care premium not broken out on this page.
Source: CareScout (Genworth) Cost of Care Survey 2025 · 2025
National median hourly rate for a non-medical in-home caregiver (home health aide / homemaker)
Measured
US-national
35 USD per hour
Who this covers: US home care (all causes)
Up 3% year over year. Skilled nursing in the home $90/hour. Facts and Figures 2026 cites the 2024 survey: home health aide $34/hr, $6,483/month; adult day services $100/day.
Source: CareScout (Genworth) Cost of Care Survey 2025 · 2025
National median daily cost of adult day services
Measured
US-national
100 USD per day
Who this covers: US adult day services users
$104 in 2025 dollars; grew 5.6%/yr 2021-2024 before inflation adjustment.
Source: Alzheimer's Association 2026 Facts and Figures, citing Genworth/CareScout 2024 Cost of Care Survey · 2024
Total Medicaid spending on long-term services and supports
Measured
US-national
200.4 billion USD (2022 dollars)
Who this covers: All Medicaid LTSS users
$212.4B in 2025 dollars. Home- and community-based services 65%, institutional 35%. HCBS share ranges 32% (Mississippi) to 84% (Oregon).
Source: Alzheimer's Association 2026 Facts and Figures (Long-Term Care section, citing ref. 954) · 2022
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SSI resource (asset) standard for an individual, used as the countable-asset limit for Medicaid long-term care eligibility in SSI-criteria states
Measured
US-national
2,000 USD
Who this covers: Medicaid long-term care applicants (individual)
/REGULATORY (effective 1 Jan 2026). Couple $3,000. SSI federal benefit rate $994 individual / $1,491 couple. Income cap (300% FBR) $2,982/month. States using 209(b) or medically-needy rules may differ.
Source: CMS CMCS Informational Bulletin, 27 Apr 2026: Updated 2026 SSI and Spousal Impoverishment Standards · 2026
Community spouse resource allowance, federal maximum (assets the at-home spouse may keep when the other spouse enters Medicaid-covered nursing home care)
Measured
US-national
162,660 USD
Who this covers: Married Medicaid institutional/HCBS applicants
Effective 1 Jan 2026. Minimum resource standard $32,532 (states choose within range).
Source: CMS CMCS Informational Bulletin, 27 Apr 2026 · 2026
Community spouse resource allowance, federal minimum
Measured
US-national
32,532 USD
Who this covers: Married Medicaid institutional/HCBS applicants
Effective 1 Jan 2026.
Source: CMS CMCS Informational Bulletin, 27 Apr 2026 · 2026
Home equity limit for Medicaid long-term care eligibility, federal minimum (state may raise up to the maximum)
Measured
US-national
752,000 USD
Who this covers: Medicaid long-term care applicants
Effective 1 Jan 2026. Maximum $1,130,000.
Source: CMS CMCS Informational Bulletin, 27 Apr 2026 · 2026
Home equity limit for Medicaid long-term care eligibility, federal maximum
Measured
US-national
1,130,000 USD
Who this covers: Medicaid long-term care applicants
Effective 1 Jan 2026.
Source: CMS CMCS Informational Bulletin, 27 Apr 2026 · 2026
Maximum monthly maintenance needs allowance for the community spouse
Measured
US-national
4,066.5 USD per month
Who this covers: Community spouses of Medicaid LTC beneficiaries
Effective 1 Jan 2026. Minimum MMMNA $2,705 (effective 1 Jul 2026; Alaska $3,381.25, Hawaii $3,111.25). Community spouse monthly housing allowance $811.50.
Source: CMS CMCS Informational Bulletin, 27 Apr 2026 · 2026
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"Value of unpaid caregiving" means the hours families give, priced as if they had been
bought. No money changes hands. It is included because leaving it out makes the real cost look far smaller
than it is.
Lecanemab (Leqembi) IV annual wholesale acquisition cost (list price) at US launch, 10 mg/kg biweekly, 75 kg patient
Modelled estimate
US-national
26,500 USD per patient per year
Who this covers: Early Alzheimer's disease (MCI or mild dementia due to AD)
LIST PRICE (WAC), manufacturer-announced. Vial WAC: 200 mg $254.81; 500 mg $637.02. Eisai's own modelled 'societal value' was $37,600/yr. Actual annualized price varies with body weight.
Source: Eisai press release, 6 Jan 2023: Eisai's approach to U.S. pricing for LEQEMBI · 2023
Lecanemab 500 mg vial wholesale acquisition cost
Basis not stated
US-national
637.0 USD per vial
Who this covers: Early Alzheimer's disease
LIST PRICE. 200 mg vial $254.81. Implies about $1.274/mg.
Source: Eisai press release, 6 Jan 2023 · 2023
Lecanemab subcutaneous autoinjector (Leqembi Iqlik) wholesale acquisition cost per 250 mg autoinjector
Basis not stated
US-national
385 USD per autoinjector
Who this covers: Early Alzheimer's disease (at-home subcutaneous initiation or maintenance)
LIST PRICE (WAC). Subcutaneous initiation dose requires two autoinjectors (500 mg per weekly dose). Eisai states WAC does not reflect what patients pay. Statement is undated in its text but cites the 2026 Facts and Figures 'accessed April 28, 2026', so it dates from 2026 (SC initiation-dose approval).
Source: Eisai statement: LEQEMBI IQLIK U.S. pricing and access · 2026
Donanemab (Kisunla) wholesale acquisition cost per 350 mg vial
Basis not stated
US-national
695.6 USD per vial
Who this covers: Early symptomatic Alzheimer's disease
LIST PRICE. Lilly states total cost varies with treatment duration because dosing can stop once amyloid is cleared on PET. Release's 'Course of Therapy Cost' table: 6 months $12,522; 12 months $32,000; 18 months $48,696.
Source: Eli Lilly press release, 2 Jul 2024: Kisunla approved by the FDA · 2024
Donanemab (Kisunla) list-price cost of a 12-month course (13 monthly infusions)
Basis not stated
US-national
32,000 USD per patient per 12 months
Who this covers: Early symptomatic Alzheimer's disease
LIST PRICE, manufacturer-stated: 13 vials-per-infusion schedule totals $32,000 for 12 months; 6-month course $12,522; 18-month course $48,696 per the release's table. Value here is the 12-month figure.
Source: Eli Lilly press release, 2 Jul 2024 (cost table: 12-month treatment) · 2024
Japan National Health Insurance drug price for lecanemab 500 mg vial
Basis not stated
country
114,443 JPY per vial
Who this covers: MCI and mild dementia due to AD, Japan
REGULATED LIST PRICE (NHI). 200 mg vial 45,777 JPY. Implies about 229 JPY/mg. A 2026 Japanese study notes a scheduled 15% lecanemab price reduction effective 1 Nov 2025 (Makita K et al., PMID 42467046). Country: Japan.
Source: Eisai/Biogen press release, 12 Dec 2023: LEQEMBI to be launched in Japan on December 20 · 2023
Medicare Part B payment allowance limit for lecanemab (HCPCS J0174), per 1 mg, effective 1 Oct-31 Dec 2026 (ASP-based)
Basis not stated
US-national
1.361 USD per mg
Who this covers: Medicare Part B beneficiaries
NET-PRICE PROXY: payment limit = average sales price (net of manufacturer discounts/rebates to purchasers) plus statutory add-on. Coinsurance 20%. Compare WAC ~$1.274/mg (500 mg vial). Derived annual amount at 10 mg/kg biweekly for a 75 kg patient (19,500 mg/yr) would be about $26,540; that derivation is ours, not CMS's.
Source: CMS October 2026 Medicare Part B Payment Limit File (based on 2Q26 ASP data) · 2026
Medicare Part B payment allowance limit for donanemab (HCPCS J0175), per 2 mg, effective 1 Oct-31 Dec 2026 (ASP-based)
Basis not stated
US-national
4.185 USD per 2 mg
Who this covers: Medicare Part B beneficiaries
NET-PRICE PROXY (ASP-based). Equals $2.0925/mg, i.e. About $732 per 350 mg vial versus WAC $695.65 (ASP-based limit includes the statutory add-on percentage). Coinsurance 20%.
Source: CMS October 2026 Medicare Part B Payment Limit File (based on 2Q26 ASP data) · 2026
Average Medicare allowed amount per 1 mg lecanemab (J0174), physician/supplier claims, national, 2024
Measured
US-national
1.305 USD per mg
Who this covers: Medicare fee-for-service beneficiaries receiving lecanemab in office/non-facility settings
Avg_Mdcr_Alowd_Amt 1.3049; Avg_Mdcr_Pymt_Amt 1.0383 (Medicare's ~80% share; remainder is beneficiary coinsurance). 4,734 beneficiaries and 41.7 million mg in this dataset (excludes hospital outpatient department claims, so not total uptake).
Source: CMS Medicare Physician & Other Practitioners - by Geography and Service, 2024 · 2024
Average Medicare allowed amount per 2 mg donanemab (J0175), physician/supplier claims, national, 2024
Measured
US-national
4.162 USD per 2 mg
Who this covers: Medicare fee-for-service beneficiaries receiving donanemab in office/non-facility settings
Avg_Mdcr_Alowd_Amt 4.1615; Avg_Mdcr_Pymt_Amt 3.3157. 1,142 beneficiaries; 978,159 units of 2 mg.
Source: CMS Medicare Physician & Other Practitioners - by Geography and Service, 2024 · 2024
Average Medicare allowed amount for IV infusion administration, first hour (CPT 96413), office setting, national, 2024
Measured
US-national
125.2 USD per infusion
Who this covers: Medicare fee-for-service beneficiaries (all indications; code is used for lecanemab/donanemab infusions)
Medicare payment $98.25 (80%); beneficiary/supplemental coinsurance 20%. Each additional hour (96415): allowed $26.90.
Source: CMS Medicare Physician & Other Practitioners - by Geography and Service, 2024 · 2024
Average Medicare allowed amount for MRI brain without contrast (CPT 70551), office/global setting, national, 2024
Measured
US-national
155.1 USD per scan
Who this covers: Medicare fee-for-service beneficiaries (all indications; ARIA monitoring scans use this code)
Facility (professional component only) allowed $68.28. Medicare pays 80%.
Source: CMS Medicare Physician & Other Practitioners - by Geography and Service, 2024 · 2024
Modelled total annualized weight-based lecanemab medication cost per Medicare beneficiary
Modelled estimate
US-national
25,851 USD per patient per year (2023 WAC basis)
Who this covers: Medicare beneficiaries age 65+ with MCI or mild dementia (HRS 2018 weights)
From 2018 HRS body weights and WAC vial prices, 24 infusions/yr. Medicare 80% share $20,680.55; beneficiary coinsurance $5,170.14.
Source: Arbanas JC et al. Estimated Annual Spending on Lecanemab and Its Ancillary Costs in the US Medicare Program. JAMA Intern Med 2023; doi:10.1001/jamainternmed.2023.1749 (PMID 37167598) · 2023
Modelled annual ancillary costs of lecanemab treatment per Medicare beneficiary (PET, infusions, MRI, visits, APOE test, ARIA care)
Modelled estimate
US-national
7,330 USD per patient per year (2022 Medicare fee schedule)
Who this covers: Medicare beneficiaries age 65+ with MCI or mild dementia
Components (Medicare-approved unit cost x events/yr): amyloid PET 1 x $1,564.88; IV infusion 24 x $133.67; neurology/geriatrics visits 4 x $155.75; routine brain MRI 3 x $445.01; APOE test 1 x $99; ARIA-related extra MRI 0.172/yr; ARIA-related visits 0.172/yr; hospitalization for severe AE 0.027 x $14,700. Ancillary costs raise per-patient total by 28%.
Source: Arbanas JC et al. JAMA Intern Med 2023 (PMID 37167598) · 2023
Modelled cost of discarded (wasted) lecanemab per patient per year due to vial sizes and weight-based dosing
Modelled estimate
US-national
1,619 USD per patient per year
Who this covers: Medicare-eligible adults with MCI or mild dementia (HRS)
5.8% of dispensed drug wasted (1.6 doses/yr). Total annual Medicare waste $133M-$336M at 1.1%-2.9% uptake. Per-unit cost assumed $1.31/mg (WAC + 3%).
Source: Zhou FF et al. Reducing Wasteful Spending on Discarded Lecanemab in the US Medicare Program. JAMA Intern Med 2024; doi:10.1001/jamainternmed.2024.5292 (PMID 39401006) · 2024
NICE final draft guidance: lecanemab recommended for routine NHS use in England (1 = yes, 0 = no)
Basis not stated
country
0 binary
Who this covers: Adults with MCI or mild dementia due to AD, APOE4 heterozygous or non-carriers, England
Zero is a real value here: NOT recommended (third negative decision). Reason: cost per QALY substantially exceeded NICE thresholds; NICE manual (PMG36) presents net health benefit at £25,000-£35,000 per QALY. NICE's own ICER figures are commercial-in-confidence. Appeal by Eisai received Oct 2025; appraisal GID-TA11220 still listed 'in progress' when fetched 22 Sep 2026. Country: UK (England/Wales).
Source: NICE news, 19 Jun 2025: Final draft guidance finds benefits of 2 Alzheimer's treatments remain too small to justify the additional costs to the NHS · 2025
NICE final draft guidance: donanemab recommended for routine NHS use in England (1 = yes, 0 = no)
Basis not stated
country
0 binary
Who this covers: Adults with MCI or mild dementia due to AD, England
Zero is a real value: NOT recommended. Delay of mild-to-moderate progression 4-6 months judged too small for purchase + administration + MRI monitoring costs. Country: UK.
Source: NICE news, 19 Jun 2025 (GID-TA11221) · 2025
Delay in progression from mild to moderate Alzheimer's cited by NICE for lecanemab and donanemab (upper bound of stated 4-6 months)
Basis not stated
country
6 months
Who this covers: MCI or mild dementia due to AD
NICE wording '4-6 months'; lower bound 4. Country: UK.
Source: NICE news, 19 Jun 2025 · 2025
CMS NCD 200.3: Medicare covers FDA-approved anti-amyloid mAbs under Coverage with Evidence Development (1 = covered with conditions)
Basis not stated
US-national
1 binary
Who this covers: Medicare beneficiaries with MCI due to AD or mild AD dementia with confirmed amyloid pathology
Effective 7 Apr 2022. Drugs approved on a surrogate endpoint (accelerated approval) covered only in RCTs under IND; drugs approved on clinical benefit (lecanemab traditional approval Jul 2023; donanemab Jul 2024) covered in CMS-approved prospective comparative studies, which may be registries. Use outside such studies is nationally non-covered. Amyloid PET in these studies also meets NCD 220.6.20 CED.
Source: CMS Medicare Coverage Database, NCD 200.3 Monoclonal Antibodies Directed Against Amyloid for the Treatment of Alzheimer's Disease · 2022
US Veterans Health Administration covers lecanemab for eligible veterans (1 = yes)
Basis not stated
US-national
1 binary
Who this covers: Veterans with MCI or mild dementia due to AD meeting VHA criteria for use
VHA coverage announced March 2023 (two months after accelerated approval), with criteria for use beyond the FDA label. A July 2025 VA San Francisco story states VA covers both lecanemab and donanemab for eligible veterans (https://www.va.gov/san-francisco-health-care/stories/slowing-the-progression-offering-access-and-hope/).
Source: Alzheimer's Association news, 13 Mar 2023: Association Applauds Coverage for Veterans Living with Alzheimer's · 2023
Modelled annual Medicare spending on lecanemab plus ancillary services, lower-bound uptake (85,687 patients)
Modelled estimate
US-national
2 billion USD per year
Who this covers: Medicare beneficiaries with MCI or mild dementia due to AD
95% CI $1.8-2.2B. Upper bound (216,536 patients): $5.1B (95% CI $4.6-5.7B). Assumes 19% attrition; excludes rebates.
Source: Arbanas JC et al. JAMA Intern Med 2023 (PMID 37167598) · 2023
Modelled annual Medicare spending on lecanemab plus ancillary services, upper-bound uptake (216,536 patients)
Modelled estimate
US-national
5.1 billion USD per year
Who this covers: Medicare beneficiaries with MCI or mild dementia due to AD
95% CI $4.6-5.7B.
Source: Arbanas JC et al. JAMA Intern Med 2023 (PMID 37167598) · 2023
Share of the estimated 1.4 million eligible US patients who could be treated with lecanemab at WAC without exceeding ICER's $777M/yr budget-impact threshold
Modelled estimate
US-national
5 percent of eligible population
Who this covers: US patients with MCI due to AD or mild AD (1.4 million eligible; 280,000/yr assumed to initiate)
Cumulative per-patient net budget impact ~$27,000 in year 1, ~$104,000 over 5 years at WAC. 9% treatable at $150k/QALY price, 16% at $100k, 59% at $50k.
Source: ICER Final Evidence Report, 17 Apr 2023 (Section 7) · 2023
Estimated annual treatment cost if all 5.4 million potentially eligible EU-27 patients received lecanemab priced as in the US
Modelled estimate
global
133 billion EUR per year
Who this covers: EU-27 early AD population potentially eligible for lecanemab
Upper-bound scenario; would exceed half of total EU pharmaceutical expenditure. Geography: EU-27 (recorded as 'global' because schema lacks a multi-country region).
Source: Jönsson L et al. The affordability of lecanemab: an EADC-EC viewpoint. Lancet Reg Health Eur 2023; doi:10.1016/j.lanepe.2023.100657 (PMID 37251789) · 2023
A cost-effectiveness ratio — dollars per QALY, a quality-adjusted life year — is not a
measurement. It is the output of a model with stated assumptions, and it encodes a judgement about how much a
year of reasonable-quality life is worth. Different modellers reach different answers from the same trial.
ICER base-case incremental cost-effectiveness ratio, lecanemab + supportive care vs supportive care, health care sector perspective
Modelled estimate
US-national
254,000 USD per QALY gained
Who this covers: MCI due to AD or mild AD dementia
Judged against ICER's $100,000-$150,000 per QALY thresholds: NOT cost-effective. Cost per life-year $277,000; per evLY $204,000. Peer-reviewed summary: Wright AC et al. J Manag Care Spec Pharm 2023 (PMID 37610113).
Source: Institute for Clinical and Economic Review, Lecanemab for Early Alzheimer's Disease: Final Evidence Report, 17 Apr 2023 (Table 4.5) · 2023
ICER base-case incremental cost-effectiveness ratio, lecanemab vs supportive care, modified societal perspective
Modelled estimate
US-national
236,000 USD per QALY gained
Who this covers: MCI due to AD or mild AD dementia
Threshold $100,000-$150,000/QALY: NOT cost-effective. Per evLY $183,000. If treatment continued until severe AD: $286,000/QALY (health care sector).
Source: ICER Final Evidence Report, 17 Apr 2023 (Table 4.5) · 2023
ICER health-benefit price benchmark for lecanemab, lower bound (annual price achieving $100,000 per QALY, health care sector)
Modelled estimate
US-national
8,900 USD per year
Who this covers: MCI due to AD or mild AD dementia
Threshold price. Full HBPB range $8,900-$21,500 (19%-66% discount from $26,500 WAC). Price to reach $150,000/QALY (health care sector) $14,600; $50,000/QALY $3,200; $200,000/QALY $20,300. Excludes 6% provider markup.
Source: ICER Final Evidence Report, 17 Apr 2023 (Tables 4.9, 6.1) · 2023
ICER health-benefit price benchmark for lecanemab, upper bound (annual price achieving $150,000 per evLY gained, societal perspective)
Modelled estimate
US-national
21,500 USD per year
Who this covers: MCI due to AD or mild AD dementia
Threshold price; 19% discount from WAC.
Source: ICER Final Evidence Report, 17 Apr 2023 (Table 6.1) · 2023
Annual lecanemab price below which CSF-test-then-targeted-treatment strategy becomes cost-effective (independent model)
Modelled estimate
US-national
5,100 USD per year
Who this covers: MCI or mild dementia due to AD
Conclusion: neither targeted nor unrestricted lecanemab was cost-effective vs standard of care at current price; standard of care alone was optimal. Base-case ICER value is in the full text, which was paywalled; not recorded here. Willingness-to-pay threshold used is stated in the full text (not in abstract).
Source: Nguyen HV, Mital S, Knopman DS, Alexander GC. Cost-Effectiveness of Lecanemab for Individuals With Early-Stage Alzheimer Disease. Neurology 2024; doi:10.1212/WNL.0000000000209218 (PMID 38484190) · 2024
Independent model ICER for donanemab vs standard care, health care sector perspective (pre-approval, phase 2 efficacy, assumed $28,000/yr price)
Modelled estimate
US-national
193,000 USD per QALY gained (2020 USD)
Who this covers: Early AD (65% MCI, 35% mild dementia), mean age 75
Willingness-to-pay threshold $150,000/QALY: NOT cost-effective. Societal ICER $176,000/QALY. QALY gain 0.408; drug cost $44,600 (dosing stops after amyloid clearance).
Source: Ross EL, Weinberg MS, Arnold SE. Cost-effectiveness of Aducanumab and Donanemab for Early Alzheimer Disease in the US. JAMA Neurol 2022; doi:10.1001/jamaneurol.2022.0315 (PMID 35344024) · 2022
Independent model ICER for aducanumab vs standard care, health care sector perspective ($28,000/yr price)
Modelled estimate
US-national
981,000 USD per QALY gained (2020 USD)
Who this covers: Early AD
Threshold $150,000/QALY: NOT cost-effective. Societal $964,000/QALY. Value-based price stayed below $50,000/yr even at 90% efficacy.
Source: Ross EL et al. JAMA Neurol 2022 (PMID 35344024) · 2022
ICER cost per QALY for aducanumab at $56,000/yr launch price, health care sector perspective (pooled trial efficacy)
Modelled estimate
US-national
1,330,000 USD per QALY gained
Who this covers: Early AD
Range $1.02M per evLYG to $1.33M per QALY. Threshold prices $2,950-$8,360/yr (85-95% discount). Judged against $100,000-$150,000/QALY thresholds: NOT cost-effective.
Source: Whittington MD et al. Cost-Effectiveness and Value-Based Pricing of Aducanumab. Neurology 2022; doi:10.1212/WNL.0000000000013314 (PMID 35022306) · 2022
Manufacturer-sponsored 'economically justifiable price' for a 1-year (13-dose) donanemab course at $150,000/QALY threshold, health care system perspective
Modelled estimate
US-national
80,538 USD per 13-dose course
Who this covers: Early symptomatic AD (TRAILBLAZER-ALZ 2 population)
MANUFACTURER-FUNDED (adapted ICER model). At $100,000/QALY: $44,691 (health system) / $55,419 (societal). At $150,000/QALY societal: $91,126. Conclusion favourable to manufacturer; contrast independent analyses.
Source: Boustani M et al. (Eli Lilly). Estimating the Economically Justifiable Price of Limited-Duration Treatment with Donanemab. Neurol Ther 2024; doi:10.1007/s40120-024-00649-y (PMID 39292433) · 2024
Manufacturer-sponsored annual value-based price of lecanemab at $100,000/QALY threshold, US payer perspective
Modelled estimate
US-national
18,709 USD per year
Who this covers: Early AD (CLARITY AD-informed simulation)
MANUFACTURER-FUNDED. Range $18,709 ($100k/QALY) to $35,678 ($200k/QALY) payer; $19,710-$37,351 societal. QALY gain 0.61. Note even this analysis's $100k-$150k value price is below the $26,500 WAC at the $100k threshold.
Source: Tahami Monfared AA et al. (Eisai). Estimated Societal Value of Lecanemab. Neurol Ther 2023; doi:10.1007/s40120-023-00460-1 (PMID 36929345) · 2023
ICER of lecanemab vs aducanumab (indirect comparison), US health system perspective
Modelled estimate
US-national
121,678 USD per QALY gained
Who this covers: Early AD
Authors conclude at current list prices neither drug is cost-effective vs standard of care; comparison here is drug-vs-drug, not vs standard care.
Source: Jiang X et al. Lifetime cost-effectiveness of lecanemab for early Alzheimer's disease. Front Public Health 2026; doi:10.3389/fpubh.2026.1692508 (PMID 41694525) · 2026
Number of published cost-effectiveness analyses of aducanumab/lecanemab/donanemab meeting inclusion in a 2026 narrative review
Basis not stated
global
16 studies
Who this covers: Early-onset/early-stage AD CEAs
REVIEW. Aducanumab ICERs $127,461-$1,581,276/QALY (2026 USD), almost all above $100k-$150k thresholds. Lecanemab mixed: manufacturer-funded models below thresholds, independent models generally above. Single donanemab-vs-SoC analysis $214,760/QALY (2026 USD). No independent study found cost savings.
Source: Nguyen TT et al. Worth their weight in gray matter? Alzheimers Dement (N Y) 2026; doi:10.1002/trc2.70267 (PMID 42253439) · 2026
Donanemab vs standard of care ICER from the single US analysis, inflated to 2026 USD by the review
Modelled estimate
US-national
214,760 USD per QALY gained (2026 USD)
Who this covers: Early AD
Above $100k-$150k/QALY thresholds.
Source: Nguyen TT et al. Alzheimers Dement (N Y) 2026 (PMID 42253439) · 2026
Cost-effective annual price of lecanemab in Sweden at willingness-to-pay of 1 million SEK per QALY (formal-care payer perspective)
Modelled estimate
country
33,886 SEK per year of treatment (2023 SEK)
Who this covers: Early AD, Sweden (biomarker-confirmed)
About US$3,200 at the paper's rate ($1 = 10.6 SEK). QALY gain 0.17; administration/monitoring net cost 87,146 SEK before drug cost. Conclusion: unlikely cost-effective at US list prices. Country: Sweden.
Source: Xia X et al. The Cost-Effective Price of Lecanemab for Patients with Early AD in Sweden. PharmacoEconomics 2025; doi:10.1007/s40273-025-01527-7 (PMID 40730714) · 2025
ICER of donanemab vs standard care in Australia, healthcare perspective
Modelled estimate
country
342,424 AUD per QALY gained
Who this covers: Early symptomatic AD, APOE4 non-homozygous, Australia
Societal $294,701/QALY. Exceeds 'frequently cited Australian willingness-to-pay thresholds' (specific threshold not given in abstract). Country: Australia.
Source: Gao L, Watson R, Yassi N. Cost-Effectiveness of Donanemab for Early Alzheimer Disease in Australia. Med J Aust 2026; doi:10.5694/mja2.70186 (PMID 42015793) · 2026
ICER of lecanemab + SoC vs SoC in South Korea, healthcare payer perspective
Modelled estimate
country
198,171,820 KRW per QALY gained
Who this covers: Early symptomatic AD, South Korea
Willingness-to-pay threshold 30 million KRW/QALY: NOT cost-effective (ICER ~6.6x threshold). Limited societal perspective 181,185,820 KRW/QALY. Lecanemab non-reimbursed in Korea per authors. Country: South Korea.
Source: Shin S, Kim M, Hong SH. Economic Evaluation of Lecanemab for Early Symptomatic AD in South Korea. Pharmacoecon Open 2025; doi:10.1007/s41669-025-00593-z (PMID 40685475) · 2025
Cost per QALY gained, lecanemab vs acetylcholinesterase-inhibitor standard of care, Brazil healthcare perspective
Modelled estimate
country
2,098,225 USD per QALY gained (2024 USD)
Who this covers: Mild AD, Brazil
Donanemab vs lecanemab $1,460,400/QALY. Standard of care vs no drug $5,211/QALY. Threshold not stated in abstract. Country: Brazil.
Source: Price PU et al. Evaluating the Cost-Effectiveness of Pharmacological Therapy in AD in Brazil. Value Health Reg Issues 2025; doi:10.1016/j.vhri.2025.101130 (PMID 40435868) · 2025
ICER of lecanemab + SoC vs SoC for MCI due to AD in Japan, public healthcare + long-term care payer perspective (manufacturer-affiliated)
Modelled estimate
country
8,500,000 JPY per QALY gained
Who this covers: MCI due to AD, Japan
Author list includes Eisai-affiliated authors (Tomita K et al.) - treat as manufacturer-affiliated. Mild AD dementia: JPY 7.9M/QALY. Includes caregiver utilities. Threshold not stated in abstract (Japan's cost-effectiveness evaluation reference is JPY 5M/QALY, not verified here). Country: Japan.
Source: Igarashi A et al. The social value of lecanemab for patients with early AD in Japan. J Alzheimers Dis 2026; doi:10.1177/13872877261447312 (PMID 42108615) · 2026
Total Medicaid payments for people age 65+ with Alzheimer's or other dementias, Alabama
Modelled estimate
US-state
1,277 million USD (2025 dollars)
Who this covers: Medicaid beneficiaries age 65+ with dementia, Alabama
Small-area estimate (Lewin Model); do not treat as measured state expenditure.
Source: Alzheimer's Association, 2026 Alzheimer's Disease Facts and Figures, Table 22 (Lewin Model) · 2025
Total Medicaid payments for people age 65+ with Alzheimer's or other dementias, Montana
Modelled estimate
US-state
230 million USD (2025 dollars)
Who this covers: Medicaid beneficiaries age 65+ with dementia, Montana
Small-area estimate (Lewin Model); do not treat as measured state expenditure.
Source: Alzheimer's Association, 2026 Alzheimer's Disease Facts and Figures, Table 22 (Lewin Model) · 2025
Total Medicaid payments for people age 65+ with Alzheimer's or other dementias, Alaska
Modelled estimate
US-state
125 million USD (2025 dollars)
Who this covers: Medicaid beneficiaries age 65+ with dementia, Alaska
Small-area estimate (Lewin Model); do not treat as measured state expenditure.
Source: Alzheimer's Association, 2026 Alzheimer's Disease Facts and Figures, Table 22 (Lewin Model) · 2025
Total Medicaid payments for people age 65+ with Alzheimer's or other dementias, Nebraska
Modelled estimate
US-state
465 million USD (2025 dollars)
Who this covers: Medicaid beneficiaries age 65+ with dementia, Nebraska
Small-area estimate (Lewin Model); do not treat as measured state expenditure.
Source: Alzheimer's Association, 2026 Alzheimer's Disease Facts and Figures, Table 22 (Lewin Model) · 2025
Total Medicaid payments for people age 65+ with Alzheimer's or other dementias, Arizona
Modelled estimate
US-state
617 million USD (2025 dollars)
Who this covers: Medicaid beneficiaries age 65+ with dementia, Arizona
Small-area estimate (Lewin Model); do not treat as measured state expenditure.
Source: Alzheimer's Association, 2026 Alzheimer's Disease Facts and Figures, Table 22 (Lewin Model) · 2025
Total Medicaid payments for people age 65+ with Alzheimer's or other dementias, Nevada
Modelled estimate
US-state
314 million USD (2025 dollars)
Who this covers: Medicaid beneficiaries age 65+ with dementia, Nevada
Small-area estimate (Lewin Model); do not treat as measured state expenditure.
Source: Alzheimer's Association, 2026 Alzheimer's Disease Facts and Figures, Table 22 (Lewin Model) · 2025
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Economic value of unpaid dementia caregiving, Alabama
Modelled estimate
US-state
6,391 million USD (2025 dollars)
Who this covers: Unpaid caregivers of people with Alzheimer's or other dementias, Alabama (222 thousand caregivers; 396 million hours)
State totals do not sum to US total due to rounding.
Source: Alzheimer's Association, 2026 Alzheimer's Disease Facts and Figures, Table 10 · 2025
Economic value of unpaid dementia caregiving, Montana
Modelled estimate
US-state
652 million USD (2025 dollars)
Who this covers: Unpaid caregivers of people with Alzheimer's or other dementias, Montana (18 thousand caregivers; 26 million hours)
State totals do not sum to US total due to rounding.
Source: Alzheimer's Association, 2026 Alzheimer's Disease Facts and Figures, Table 10 · 2025
Economic value of unpaid dementia caregiving, Alaska
Modelled estimate
US-state
929 million USD (2025 dollars)
Who this covers: Unpaid caregivers of people with Alzheimer's or other dementias, Alaska (25 thousand caregivers; 40 million hours)
State totals do not sum to US total due to rounding.
Source: Alzheimer's Association, 2026 Alzheimer's Disease Facts and Figures, Table 10 · 2025
Economic value of unpaid dementia caregiving, Nebraska
Modelled estimate
US-state
1,617 million USD (2025 dollars)
Who this covers: Unpaid caregivers of people with Alzheimer's or other dementias, Nebraska (42 thousand caregivers; 63 million hours)
State totals do not sum to US total due to rounding.
Source: Alzheimer's Association, 2026 Alzheimer's Disease Facts and Figures, Table 10 · 2025
Economic value of unpaid dementia caregiving, Arizona
Modelled estimate
US-state
9,700 million USD (2025 dollars)
Who this covers: Unpaid caregivers of people with Alzheimer's or other dementias, Arizona (242 thousand caregivers; 379 million hours)
State totals do not sum to US total due to rounding.
Source: Alzheimer's Association, 2026 Alzheimer's Disease Facts and Figures, Table 10 · 2025
Economic value of unpaid dementia caregiving, Nevada
Modelled estimate
US-state
5,651 million USD (2025 dollars)
Who this covers: Unpaid caregivers of people with Alzheimer's or other dementias, Nevada (137 thousand caregivers; 226 million hours)
State totals do not sum to US total due to rounding.
Source: Alzheimer's Association, 2026 Alzheimer's Disease Facts and Figures, Table 10 · 2025
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