An Open Letter to Highmark and Independence Blue Cross

Below is an open letter to Highmark Blue Cross and Independence Blue Cross written by Dr. David Weisman and co-signed by other practicing neurologists and geriatricians. The letter addresses the urgent need for insurance coverage of lecanemab, an FDA-approved medication proven to slow the progression of Alzheimer’s disease.

Highmark and Independence refuse to cover lecanemab despite the new medication’s proven efficacy in treating Alzheimer’s disease. Furthermore, they are publicly issuing false and misleading statements to justify this decision.

Denial of coverage for lecanemab will have devastating consequences for millions of patients and families. Thus far, efforts to engage Independence have failed, with their spokesperson saying, “A discussion with you to debate our position will not be fruitful.”

If you have any questions or concerns, we recommend that you reach out to your state representative or directly contact Highmark or IBC.

To Whom it May Concern:

We are writing to formally request coverage for a medication, lecanemab, that is FDA-approved to slow progression in patients diagnosed with mild Alzheimer’s disease. This medication concluded phase 2 and 3 trials, and had significant efficacy with acceptable risk. We believe that this medication will improve outcomes for these patients. Your non-coverage decision takes away autonomy, stigmatizes, and unfairly discriminates against those with the disease.

Alzheimer’s disease is a progressive neurodegenerative disorder. As it progresses, it takes an immense toll on overall well-being. The impact is not limited to the patient; their families also bear emotional and financial burdens.

You may be aware that lecanemab received traditional approval from the U.S. Food and Drug Administration (FDA). Clinical trials show this medication slows the progression of cognitive decline. On the primary outcome measure, the Clinical Dementia Rating (CDR) Dementia Staging Instrument, the medication slowed progression by 27%, which equates to 5.3 months stabilization over a 1.5 year trial.1 In addition to positive clinical and biomarker secondary outcome measures, those looking at caregiver burden were also positive.

This medication represents quite a bit: the work of many thousands of researchers and study subjects, dozens of years of dozens of failed trials, human ingenuity and financial risk on a tough disease to crack, all culminating in real hope for our patients.

The medication, like any other, has risk. Although infusion reactions were well tolerated, this class of medications causes brain edema. With monitoring and by excluding high risk patients, we feel we can keep this side effect mild, asymptomatic, and manageable.

Given the completed trials and the data, calling this medication “experimental” is false. Your spokeswoman said, “existing evidence does not allow for conclusions to be drawn about the safety and effectiveness of Leqembi.” This is false.

We request that you offer coverage for lecanemab. We understand the financial drivers that sway your decision. Instead, we ask you to focus on your policyholder’s well-being; your organization values, your ideals, and non-discrimination policies; and the stage you set for further innovative therapies.

Please review our letter promptly. We seek a correction to the false statements and a timely reversal. Thank you for your attention to this matter. We remain hopeful that we can make a positive impact on the lives of those battling this fatal, devastating disease.


David Weisman, MD
Abington Neurological Associates
Founder and Director: Clinical Research ANA

Nataliya Dementovych, MD
Medical Director of Geriatrics at Lansdale Hospital

Jennifer V Frabizzio, MD
Radiology Group of Abington, Neuroradiology
President AMH Medical Staff (former)

Gediminas Gliebus, MD
Global Neurosciences Institute
Director, Cognitive Disorders Center

Todd Goldberg, MD
Jefferson Abington Hospital
Geriatrics Program Director

Dan Gzesh, MD
Abington Neurological Associates
Chief Neurology Division at Abington (former)

Mijail D. Serruya, MD, PhD
Assistant Professor, Thomas Jefferson University
Co-Director, Center for Neurorestoration

Jamie Swanson, MD
Jefferson Abington Hospital
Staff Physician

  1. (van Dyck CH et al. N Engl J Med 2023;388:9-21)