Health Canada has conditionally approved the drug lecanemab for the treatment of early-stage Alzheimer’s disease, sparking discussions on its efficacy and accessibility in Canada. Lecanemab, an artificial antibody administered via intravenous infusion, targets the accumulation of amyloid plaque in the brain, a key characteristic of Alzheimer’s disease.

Although lecanemab is not a cure and cannot reverse the disease or restore lost memories, it represents the first disease-modifying Alzheimer’s treatment approved for use in Canada. Current medications focus on symptom management rather than altering the disease’s progression.

The approval of lecanemab has prompted considerations regarding its effectiveness and potential impact on Canada’s healthcare systems for individuals with Alzheimer’s, their families, healthcare providers, and governmental bodies.

Eligibility for lecanemab, also known as Leqembi, is limited to individuals with mild cognitive impairment and early stages of Alzheimer’s disease. Patients must demonstrate the presence of amyloid plaque in the brain and undergo testing for gene variants linked to potential adverse effects, particularly the APOE4 gene variant. Genetic testing availability varies across provinces and territories.

Dr. Sharon Cohen, medical director at Toronto Memory Program, highlights the significance of having a disease-slowing medication like lecanemab as a foundation for further therapeutic advancements in Alzheimer’s treatment.

Concerns have been raised regarding the drug’s cost, with questions about its effectiveness and whether the benefits justify the expense. Ongoing research is deemed necessary to evaluate the medication’s impact on patient independence and overall outcomes.

The treatment process involves specialized diagnostics to confirm eligibility, followed by regular intravenous infusions every two weeks, lasting about an hour per session. Continued monitoring through PET scans or MRIs is essential to ensure safety and effectiveness.

The Canadian Consortium on Neurodegeneration in Aging has identified potential side effects from clinical trials, including brain swelling or bleeding associated with antibody treatments like lecanemab. Dr. Howard Chertkow emphasizes the need for further research to determine specific subgroups that would benefit most from the medication.

Advocacy is underway for swift public funding and market availability of lecanemab in Canada to ensure affordability for all eligible patients, given its approximate annual cost of $26,000 US in other countries. The process of public coverage for new medicines post-regulatory approval can take up to two years, with potential earlier access through private or extended benefits.

In 2024, Britain’s National Institute for Health and Care Excellence (NICE) concluded that the benefits of lecanemab may not justify the associated costs for the publicly-funded health system, encompassing the provision of treatment and monitoring for side effects.