A new study from UCLA reveals that access to lecanemab, a costly infusion therapy for Alzheimer’s disease, is heavily skewed toward white, urban, affluent men—raising serious concerns about equity in dementia care. Researchers found that among 1,725 Medicare beneficiaries who received the drug between July 2023 and March 2024, 90.5% were white, 88.0% lived in urban areas, and 98.7% were not socioeconomically disadvantaged.
The disparities were stark. Uptake was six times higher among white patients compared to Black patients, and 24 times higher among those with higher socioeconomic status. “This drug is contributing to increased Medicare spending for everyone, while only being provided to a select few,” said Frank Zhou, the study’s lead author.
Lecanemab, priced at $26,000 annually with an additional $7,000 in related costs, was the first Alzheimer’s therapy to receive broad Medicare coverage. Despite manufacturer assistance programs, barriers such as high costs, complex testing, and the need for in-person infusions at specialized centers have limited access for many.
“These findings should alert policymakers,” Zhou said. Co-author Dr. John Mafi added that the pattern reflects “a broader and recurring historical pattern of inequities in access to breakthrough therapies in the United States.”
The study calls for Medicare to evaluate real-world data to determine whether continued coverage is justified, especially given the drug’s modest benefits and safety risks. Researchers suggest that investing in caregiver support may be a more equitable and effective use of resources.
See “Large disparities in adoption of Alzheimer’s infusion therapy raise concerns about access” (May 15, 2025)