Will insurance cover Kisunla treatment?

Kisunla treatment typically requires a prior authorization approval from your commercial insurance company before they will pay for it. Medicare Part B may pay for Kisunla and brain imaging scans if you are eligible, but you must first meet your yearly deductible and then pay coinsurance costs, which are usually 20%.

Eli Lilly also plans to donate Kisunla to the Lilly Cares Foundation, a separate nonprofit organization that makes medicines available at no cost to those who qualify, including some eligible Medicare beneficiaries who meet financial requirements.

For Medicare enrollees, your healthcare provider must be enrolled in a special program called Coverage With Evidence Development (CED) to help track the drug’s effectiveness.

Is Kisunla used for early Alzheimer's?

Yes, Kisunla (donanemab-azbt) is an amyloid beta-directed monoclonal antibody used to treat people with early symptoms of Alzheimer’s disease. Treatment should be started in patients with mild cognitive impairment (MCI) or mild dementia stage of disease, the population in which treatment was started in studies.

Alzheimer's disease is a brain disorder that leads to memory loss over time. It is most common in people over the age of 65 years, but sometimes it can start earlier. In Alzheimer's disease, parts of the brain change with nerve cell death and tissue loss. This can lead to problems with memory, clear thinking, appropriate behavior, self-care and normal activities of daily living.

There is no cure for Alzheimer's disease at this time, but there are medications that can help reduce the symptoms and slow down the decline.

How much does Kisunla cost?

The price of Kisunla, as reported by the manufacturer, is $695.65 per vial. Estimated costs are:

• $12,522 for a 6-month course of therapy
• $32,000 for a 12-month course of therapy
• $48,696 for an 18-month course of therapy

Your out-of-pocket cost for treatment will depend upon your benefit plan, length of treatment, imaging tests (MRI, PET scans), costs associated with a monthly intravenous (IV) infusion and any additional clinic charges.

Contact Lilly Support Services for Kisunla for assistance with coverage determination, nurse navigator support, and customized support and resources. Also speak with your healthcare provider about the logistics of treatment and infusion centers.

Visit the Drugs.com Kisunla Price Guide, Coupons, Copay Cards & Patient Assistance information to learn more.

For more information on Kisunla, you can also call Eli Lilly at 1-800-LillyRx (1-800-545-5979).

Related questions

• What are monoclonal antibodies?
• How do I decide between Leqembi and Kisunla?
• What is the controversy surrounding Leqembi?

How long do you stay on Kisunla?

Kisunla is given as a once-monthly, 30-minute IV infusion. Your healthcare provider will determine how long you should continue treatment.

You may be able to stop treatment if a brain amyloid PET (positron emission tomography) scan shows that adequate amyloid plaques have been removed. A shorter treatment time, compared to some other therapies, may help lower any associated costs.

• In studies, Kisunla reduced amyloid plaques in the overall population on average by 61% at 6 months, 80% at 12 months, and 84% at 18 months compared to the start of the study, via amyloid PET. Dosing was continued or stopped in response to observed effects on amyloid imaging.
• The percentages of patients eligible for a switch to placebo based on amyloid PET levels was 17% at Week 24, 47% at Week 52, and 69% at Week 76.

This is not all the information you need to know about Kisunla (donanemab-azbt) for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.