Cost and Kisunla: Financial Assistance Options, Savings, More

Kisunla can sound like a promising treatment option for early symptomatic Alzheimer’s diseaseuntil someone asks, “So, what will this actually cost?” That question is less like opening a price tag and more like opening a nesting doll. Inside the medication cost are insurance rules, infusion-center charges, brain scans, genetic testing, deductibles, coinsurance, transportation, and enough paperwork to make a filing cabinet nervous.

Kisunla, whose generic name is donanemab-azbt, is an anti-amyloid antibody approved for people with mild cognitive impairment or mild dementia due to Alzheimer’s disease. It is given by intravenous infusion every four weeks. It is not a cure, but clinical studies found that it can slow cognitive and functional decline in appropriately selected patients with confirmed amyloid pathology.

The important financial takeaway is that Kisunla’s list price is not necessarily what a patient pays. Coverage, supplemental insurance, manufacturer programs, charitable grants, and the length of treatment can dramatically change the final out-of-pocket amount.

How Much Does Kisunla Cost?

As of July 2026, the published list price of Kisunla is $724.61 per 350-milligram single-dose vial. The list price, also called the wholesale acquisition cost, is the amount the manufacturer charges wholesalers before insurance adjustments, negotiated rates, rebates, or financial assistance. It should not be mistaken for a personalized patient bill.

How Kisunla dosing affects the medication cost

The current recommended dosing schedule gradually increases the dose during the first four infusions:

• Infusion 1: 350 milligrams, requiring one vial
• Infusion 2: 700 milligrams, requiring two vials
• Infusion 3: 1,050 milligrams, requiring three vials
• Infusion 4 and later: 1,400 milligrams, requiring four vials per infusion

Each infusion is administered approximately every four weeks and generally takes about 30 minutes, although preparation, check-in, monitoring, and post-infusion observation make the actual appointment longer.

These examples use the current vial list price and recommended dosing schedule. They represent the medication only. They do not include negotiated insurance rates, infusion services, testing, imaging, physician fees, or financial assistance.

Can Kisunla treatment stop before 18 months?

Possibly. Kisunla is unusual among Alzheimer’s infusion treatments because clinicians may consider stopping it after amyloid plaques have been reduced to minimal levels on an amyloid PET scan. In the main clinical study, treatment-stopping decisions were evaluated at specific imaging intervals, and some participants reached the required amyloid thresholds earlier than others.

At weeks 24, 52, and 76, approximately 17%, 47%, and 69% of treated participants, respectively, qualified to stop active treatment under the study’s amyloid criteria. A shorter course can mean fewer infusions and lower total costs, although follow-up imaging and the individual treatment plan still matter.

Costs Beyond the Kisunla Medication

Focusing only on the price of the drug is like budgeting for a vacation by counting the plane ticket but forgetting the hotel, meals, and suspiciously expensive airport sandwich. Kisunla treatment involves several related medical services.

Evaluation and amyloid confirmation

Before treatment begins, the clinician must confirm that the patient has amyloid beta pathology. Confirmation may involve an amyloid PET scan or cerebrospinal fluid testing. The patient also needs clinical evaluation showing mild cognitive impairment or mild dementia due to Alzheimer’s diseasenot moderate or advanced dementia.

APOE genetic testing

The prescribing information recommends testing for APOE ε4 status before treatment to help evaluate the risk of amyloid-related imaging abnormalities, commonly called ARIA. People with two APOE ε4 copies have a higher ARIA risk than people with one or no copies. Genetic counseling or a detailed discussion may also be appropriate because genetic information can have implications beyond the immediate treatment decision.

MRI monitoring

A recent baseline brain MRI is required before Kisunla begins. Under the current prescribing information, additional MRIs should be obtained before the second, third, fourth, and seventh infusions. More scans may be needed if symptoms or imaging findings suggest ARIA. Depending on the insurance plan, every scan may involve a separate deductible, coinsurance charge, facility fee, or prior authorization.

Infusion-center services

The facility may bill separately for medication preparation, intravenous administration, nursing care, supplies, physician supervision, and post-infusion observation. Hospital outpatient departments sometimes cost more than independent infusion centers, although the safest or most appropriate location should always be determined by the care team and insurance networknot simply by whichever building has the cheaper parking.

Indirect household expenses

Families should also budget for transportation, meals, parking, caregiver time, missed work, hotel stays for long-distance treatment, and additional appointments. These costs may appear small individually, but monthly visits can turn them into a meaningful household expense.

Does Medicare Cover Kisunla?

Medicare covers Kisunla under Medicare Part B when the patient meets the applicable clinical and coverage requirements. Because Kisunla received traditional FDA approval, Medicare coverage is available under the national policy for anti-amyloid monoclonal antibodies used to treat Alzheimer’s disease.

Qualifying patients generally must have mild cognitive impairment due to Alzheimer’s disease or mild Alzheimer’s dementia, confirmed amyloid pathology, and treatment from a clinician participating in an approved registry or qualifying data-collection study. The prescribing clinician or staff submits required information to the CMS registry.

Original Medicare costs

Under Original Medicare, infused medications administered by a licensed medical provider are generally handled under Part B rather than the Part D pharmacy benefit. After the annual Part B deductible is met, beneficiaries commonly pay up to 20% of the Medicare-approved amount for a covered Part B drug.

That percentage can be financially substantial with a high-cost infusion therapy. However, the patient’s actual responsibility may be reduced by Medigap, Medicaid, a retiree plan, an employer plan, or a Medicare Savings Program. The Medicare-approved amount may also differ from the manufacturer’s list price.

Medigap coverage

Medigap policies are designed to help pay some of the deductibles, copayments, and coinsurance left by Original Medicare. Depending on the specific standardized plan and enrollment circumstances, Medigap may cover much or nearly all of the Part B coinsurance associated with covered Kisunla treatment.

People considering Medigap should not cancel existing coverage or switch plans casually. Outside protected enrollment periods, medical underwriting may apply in many states, and obtaining a new policy can be more difficult or expensive.

Medicare Advantage coverage

Medicare Advantage plans must follow applicable Medicare coverage requirements, but they may use provider networks, prior authorization, copayments, or coinsurance structures that differ from Original Medicare. Ask the plan whether the neurologist, imaging center, laboratory, and infusion site are all in network. One out-of-network service can turn an otherwise sensible estimate into an unpleasant surprise wearing a necktie.

Medicare Savings Programs and Medicaid

People with limited income and resources should apply for a Medicare Savings Program through their state, even if they assume they will not qualify. Certain programs can help pay Part B premiums, deductibles, coinsurance, and copayments. People enrolled in both Medicare and Medicaid may receive additional assistance with Medicare cost sharing, subject to state rules.

Kisunla Financial Assistance and Savings Options

1. Lilly Support Services

Lilly Support Services can help patients and medical offices investigate insurance benefits, estimate treatment expenses, navigate prior authorization, coordinate care, locate participating infusion centers, and connect patients or caregivers with nurse support.

A benefits investigation is especially valuable because it can identify whether Kisunla is covered, which site of care is preferred, what authorization documents are required, and what the estimated out-of-pocket responsibility may be. Patients can reach Lilly Support Services at 1-800-LillyRx (1-800-545-5979).

2. Kisunla Savings Card

Eligible commercially insured patients whose plans cover Kisunla may qualify to pay as little as $0 per infusion for the medication. Eligibility requirements and monthly or annual program limits apply.

The savings card is not available to people whose treatment is paid for by Medicare, Medicaid, TRICARE, Veterans Affairs benefits, or other government-funded insurance. It is also not insurance, and it may not cover imaging, testing, infusion administration, facility charges, or other treatment-related services. Patients should verify the current terms before assuming that “$0 per infusion” means the entire appointment is free.

3. Lilly Cares Foundation

Lilly Cares is an independent nonprofit patient-assistance program that provides certain donated Lilly medications at no cost for up to 12 months to qualifying U.S. patients with financial need. Eligibility may depend on residency, the prescribed medication, insurance status, income, and other program rules.

Because medication lists and requirements can change, patients should confirm that Kisunla is currently available through the program and obtain the correct application. Lilly Cares can be reached at 1-800-545-6962.

4. Independent charitable foundations

Independent nonprofit organizations sometimes offer grants for medication coinsurance, insurance premiums, transportation, or other qualified healthcare expenses. Disease funds may open and close depending on donations, so availability can change faster than a family group chat after someone asks who is driving to the appointment.

Programs such as Patient Advocate Foundation’s TotalAssist allow people to search by disease or medication and may offer waiting-list notifications when a fund is unavailable. Never pay an application fee to apply for a legitimate charitable copay grant.

5. Free Medicare counseling

State Health Insurance Assistance Programs provide free, unbiased, one-on-one Medicare counseling. A SHIP counselor can help compare Original Medicare, Medicare Advantage, Medigap, Medicaid, and Medicare Savings Program options without selling an insurance plan. The national SHIP locator can be reached at 877-839-2675.

6. Clinical trials

Some people may qualify for clinical research involving donanemab or related Alzheimer’s treatments. A study may cover the investigational medication and certain research-related services, but it may not cover every healthcare expense, and participation is never guaranteed.

Clinical trials have strict inclusion criteria and should not be viewed merely as a free-medication program. Discuss the risks, possible placebo assignment, travel demands, and financial terms with the study team.

Ways to Lower Kisunla-Related Expenses

Request a complete written estimate

Ask the neurology office or infusion center for an estimate that separates the drug, infusion administration, facility fee, MRIs, amyloid testing, laboratory work, physician visits, and genetic testing. A single number labeled “estimated treatment cost” may leave half the financial story hiding under the rug.

Confirm the site of care

Ask whether the insurer requires a particular infusion center or prefers a lower-cost site. Confirm network status with both the facility and the insurance company. “They take your insurance” is not always the same as “they are in your plan’s network.”

Complete prior authorization before scheduling

Commercial insurers and Medicare Advantage plans may request cognitive testing, amyloid confirmation, MRI findings, diagnosis codes, treatment-stage documentation, or registry information. Starting an infusion before authorization is finalized can leave the patient responsible for a very large bill.

Appeal a denial

An initial denial is not necessarily the final decision. Ask for the denial reason in writing, the plan’s clinical policy, the appeal deadline, and the exact missing documentation. The prescriber may submit a letter of medical necessity, peer-to-peer review request, updated test results, or corrected coding.

Track every expense

Keep a folder containing explanation-of-benefits statements, receipts, authorization numbers, grant letters, savings-card records, mileage, parking costs, and names of representatives. Memory should not be the family’s accounting softwareespecially during Alzheimer’s treatment.

Real-World Experiences When Planning for Kisunla Costs

The following examples are composite planning scenarios rather than reports from individual patients. They illustrate the types of financial experiences families may encounter.

Experience 1: Medicare coverage with a Medigap policy

A retired couple begins the process assuming the medication will cost more than $30,000 per year out of pocket. That number causes several sleepless nights and at least one spreadsheet with aggressive red formatting.

After a benefits investigation, they learn that Medicare Part B will cover the treatment because the patient meets the clinical requirements and the neurologist participates in the required registry. Their Medigap plan covers most of the remaining Part B coinsurance. Their largest direct expenses are the annual Part B deductible, transportation, parking, meals, and a few services processed differently from the infused drug.

The lesson is simple: the list price can be frightening, but it does not reveal the actual patient responsibility. Checking supplemental coverage before making assumptions can completely change the financial picture.

Experience 2: Commercial insurance and a savings card

A working patient has employer-sponsored insurance with a high deductible. The insurer agrees to cover Kisunla but requires prior authorization, amyloid confirmation, baseline imaging, and an in-network infusion center.

The manufacturer savings card reduces the eligible medication cost substantially. However, the family still receives bills for MRI services, specialist visits, infusion administration, and the facility. The first estimate did not include all these items, so the “$0 medication copay” initially sounded more magical than it actually was.

The family eventually asks the center for a line-by-line estimate before each major stage of care. They also use a flexible spending account for eligible expenses and schedule infusions early in the day to reduce missed work. Their main savings come from combining the card with careful network management rather than relying on one program alone.

Experience 3: An initial insurance denial

Another family receives a denial stating that the submitted records did not adequately document confirmed amyloid pathology and disease stage. The wording feels final, but the neurologist’s office discovers that the insurer did not receive one imaging report and used an outdated cognitive assessment.

The office resubmits the missing report, updated scores, treatment rationale, and MRI information. Coverage is approved on appeal. The delay is frustrating, but it also prevents treatment from starting before the financial authorization is secure.

The practical lesson is to ask why a claim was denied rather than simply asking whether it was denied. A missing document, incorrect billing code, out-of-network location, or incomplete prior-authorization form may be fixable.

Experience 4: A family budgets for time, not just bills

A daughter serving as her father’s primary caregiver discovers that the financial burden is not limited to medical statements. Each infusion requires driving, appointment coordination, medication-list updates, observation time, meals, and occasional schedule changes. MRI appointments add more trips, while insurance phone calls seem to operate in a time zone where every minute lasts three minutes.

The family creates a shared calendar, keeps digital copies of all documents, and assigns one person to insurance calls. They ask relatives to rotate transportation and contact local aging-service organizations about ride programs. These steps do not reduce the drug’s price, but they lower lost wages, missed appointments, and caregiver exhaustion.

This experience highlights an often-overlooked truth: a treatment can be technically covered yet still difficult to access. A realistic Kisunla budget should include money, time, transportation, and caregiver capacity.

Questions families found most useful

• Is Kisunla covered under the medical benefit or pharmacy benefit?
• Has prior authorization been approved in writing?
• Is the neurologist participating in the required Medicare registry?
• Are the infusion center and imaging facility in network?
• What will the drug, administration, and facility charges be separately?
• Which costs count toward the deductible or out-of-pocket maximum?
• Does supplemental insurance cover Part B coinsurance?
• Is the patient eligible for a savings card or patient-assistance program?
• How often will MRIs and amyloid PET scans be needed?
• Who handles appeals if coverage is denied?

Conclusion

Kisunla is an important treatment option for some adults with early symptomatic Alzheimer’s disease, but its cost cannot be summarized by one price. At the current list price, approximately one year of medication may exceed $33,000 before insurance adjustments, while a longer course can cost considerably more. The patient’s actual responsibility may be far loweror occasionally still substantialdepending on Medicare, Medigap, Medicare Advantage, Medicaid, commercial insurance, treatment duration, and assistance-program eligibility.

The best strategy is to investigate benefits before the first infusion, obtain written authorization, confirm every provider’s network status, ask for an itemized estimate, and apply for all available assistance. The paperwork may be tedious, but a few careful phone calls can be worth thousands of dollars.

Note: Pricing, insurance policies, assistance-program terms, and grant availability can change. This article is for general educational purposes and is not a substitute for medical, insurance, legal, or financial advice. Patients and caregivers should verify current information with the prescribing clinician, insurer, infusion center, Medicare, and relevant assistance program.