Newly licensed Alzheimer’s drug, lecanemab, not available on NHS
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Alzheimer's Research UK
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On 22 August 2024
This blog was edited on Tuesday 11 February 2025 in response to the Scottish Medicines Agency’s ruling for lecanemab to not become available on the NHS in Scotland.
In August 2024 The UK’s medicines regulator, the Medicines and Healthcare products Regulatory Agency (MHRA) – approved the Alzheimer’s drug lecanemab for sale in Great Britain.
However, a provisional decision, made by the National Institute of Health and Care Excellence (NICE), means people in the early stages of Alzheimer’s are denied access to lecanemab through the NHS. NICE concluded that the treatment does not offer good value for money. For the foreseeable future, only those who can afford its steep price will access it privately.
Alzheimer’s disease is the most common type of dementia, affecting six in every 10 people with the condition in the UK. Current treatments can temporarily relieve symptoms, but do not slow the disease’s progression.
The MHRA’s landmark decision makes lecanemab the first licensed treatment in England, Scotland and Wales that can slow down early-stage Alzheimer’s disease, rather than manage people’s symptoms.
Alzheimer’s Research UK’s Chief Executive, Hilary Evans-Newton, described the news as “bittersweet.”
“It’s a remarkable achievement that science is now delivering licensed treatments that can slow down the devastating effects of Alzheimer’s, rather than just alleviating its symptoms. However, it’s clear our health system isn’t ready to embrace this new wave of Alzheimer’s drugs,” she explained.
What is lecanemab?
Lecanemab (lek-an-e-mab), also called LEQEMBI®, is made by the drug company Eisai. Doctors administer it through an infusion into the arm. The antibody-based treatment targets and removes amyloid, a hallmark protein that accumulates in the brains of people with Alzheimer’s.
The MHRA granted lecanemab a license after reviewing Eisai’s CLARITY AD Phase 3 clinical trial results, published in November 2022. The trial, which involved 1,800 patients over 18 months, demonstrated that the drug slowed participants’ cognitive decline by 27% and slowed their decline in quality of life by up to 56%.
Experts warned that, like first-generation treatments for other diseases, lecanemab has modest benefits and side effects that need careful monitoring.
Lecanemab carries the risk of a potentially serious side effect, known as ‘amyloid related imaging abnormalities’ (ARIA). This involves changes in the brain linked to swelling or bleeding, detectable through MRI scans.
During the trial, about one in eight people who received lecanemab developed ARIA, although 80% of them showed no symptoms. Four deaths occurred during the trial, possibly linked to lecanemab treatment. Researchers have debated the specific cause of death in these cases, suggesting that underlying health conditions and other factors may have contributed.
Who can receive lecanemab?
Until the NHS approves lecanemab, people can only access it privately.
The MHRA’s license allows doctors to administer lecanemab to people diagnosed with mild Alzheimer’s disease or those with mild cognitive impairment (MCI) who also have high levels of amyloid in their brain, confirmed through PET brain scans.
Unlike other regulators worldwide, the MHRA has decided to exclude certain individuals from receiving lecanemab. This includes people who carry two copies of the APOE4 gene and those taking blood-thinning medication, as they face a higher risk of side effects. Around 15% of people with Alzheimer’s disease carry two copies of this gene.
How effective is lecanemab?
Larry Woelk, who is living with MCI, has been on the lecanemab trial since 2020. The 76-year-old retired business executive and his wife Rita, who live in East Hampshire, believe the drug has helped slow the progression of his symptoms.
“There has been some decline but it has been gradual and subtle. He is still able to live a full life. He can drive, go out on bike rides and socialise. We feel very fortunate, but we know our situation is not the case for everyone who has Alzheimer’s,” said Rita.
“We hope that the progress research is making will bring Alzheimer’s out of the shadows and encourage people when they first notice a problem to seek help and get a diagnosis.”
Speaking about why he took part in dementia research, Larry explained, “My son works in biomedical research and for around 10 years he worked in AIDS research, which has seen a lot of breakthroughs in new treatments. I found that very interesting and it motivated me to take part in this trial. It would be great to see similar developments in new treatments for Alzheimer’s and hopefully lecanemab is the start of that.”
Will lecanemab ever be available on the NHS?
Today’s decision (August 2024) from NICE is provisional, and only covers England and Wales. In the coming months, further negotiations between NICE, the NHS and lecanemab’s manufacturer, will take place – something which Evans-Newton said, “may offer a way forward.”
“But the heartbreaking reality is that those who could benefit from drugs like lecanemab don’t have time to wait,” she warned.
In a letter to the new Health Secretary, Alzheimer’s Research UK called for him to find a solution so that people with dementia in the UK don’t continue to miss out on innovative treatments.
As well as considering how to make drugs like lecanemab available, experts called for a focus on improving the way dementia is diagnosed within the NHS. Concerns have previously been raised about the NHS’s ability to deliver lecanemab, in particular because of the way people are diagnosed. This was highlighted in the BBC’s Panorama – Alzheimer’s: A Turning Point?
Lecanemab is only suitable for people in the earliest stages of Alzheimer’s who have a formal diagnosis. In 2024, the NHS revealed that dementia diagnosis rates in England were at a record high, although still below the national target of 66.7%. However, one in three people living with dementia in England never get a diagnosis, and those who do can wait up to a year.
What’s next for dementia research?
Looking ahead, experts pointed to the need to focus research efforts on developing treatments that tackle multiple different aspects of Alzheimer’s disease.
“There are now more than 160 trials underway testing over 125 experimental treatments for Alzheimer’s across the globe, including 30 in late-stage trials. Despite today’s frustrating news, it really is a matter of when, not if, new treatments become available,” said Evans-Newton.
- Read our lecanemab information page
- If you have questions about lecanemab, want to know more about dementia research or about how you and your loved ones can get involved in studies, our Dementia Research Infoline can help. You can call us on 0300 111 5 111 (9.00-5.00pm Monday to Friday – excluding bank holidays) or email infoline@alzheimersresearchuk.org.
Cost private please
Hi Mizon, thank you for your comment. We don’t have an exact cost for private lecanemab treatment, however we do know that it will be expensive and in the hundreds of thousands of pounds. This is due to having to receive the drug intravenously every other week, needing extensive screening tests and ongoing MRI scans to monitor side effects. We’ll have more information on this when private clinics start to offer the treatment. If you have any further questions, please don’t hesitate to contact our Infoline on 0300 111 5111 or infoline@alzheimersresearchuk.org
As I have Amyloid Angiopathy does this mean that I will develop Alzheimer’s ?
Hi Christine, thanks for your comment. Even though people with Alzheimer’s disease often have cerebral amyloid angiopathy (CAA) too, many people in later life have CAA but don’t develop Alzheimer’s disease. The relationship between CAA and Alzheimer’s is complex. Some research suggests that CAA is associated with an increased risk of Alzheimer’s but more research is needed to determine if CAA is a risk factor for Alzheimer’s disease. You can find more information about factors we do know affect our risk of developing diseases like Alzheimer’s on our website here https://www.alzheimersresearchuk.org/dementia-information/dementia-risk/
I am 74 years of age, my father, and his sister had Alzheimer’s, my older brother & sister also had the condition!
I have noticed the signs in myself and have had an MRI scan (awaiting results). Like most working people in Britain from the age of 15 until retirement I have paid National insurance.
To find out I can’t get the medication which would help me is very upsetting.
This is so unfair. As usual, the rich benefit and the poor suffer. How can they say effects are minimal?
Was funding from the charity put towards developing this treatment? If so, there is something broken in the system, where big pharma is profiteering from well-meaning donations.
Hi Tony, thank you for your question. Amyloid’s role in Alzheimer’s disease has been the subject of much research, including that funded by Alzheimer’s Research UK. However, we weren’t involved in funding these trials, which were carried out by the pharmaceutical company Eisai.
If getting involved in research is something that you are interested in, we have more information about taking part in research here https://www.alzheimersresearchuk.org/research/getting-involved-in-research/
is there a petition about lecanemab access to require gov. to rethink? Treatment would save a huge cost of ongoing care.
Hi Kathleen, thanks for your comment. Unfortunately, we are not aware of any petition you could sign regarding this. However, we have written to the new Health Secretary, Wes Streeting, calling for him to find a solution so that people with dementia in the UK don’t continue to miss out on innovative treatments.
will there be a public petition through Alzheimer’s Research to appeal NICEs decision to not allow Lecanemab to be used on the NHS?
I personally am devastated by this decision. I am feeling so angry and sad, I have shed many tears. If we don’t start here to find a cure then when will we start. This drug has huge potential it may not even be proving its best ability to clear the amyloid plaque. The number of participants in a drug trial is quite small. If we don’t use it on the NHS how long do we have to wait for the ‘right’ drug to come along? There must be something we can do to turn over this bad decision. Once again, Alzheimer’s and other dementias are being left on the shelf. I feel so many people who do not understand this disease (and other dementias) are happy to ‘sweep it under the carpet’.
Hi Sarah, thank you for your comment. We have written to the new Health Secretary, Wes Streeting. Alzheimer’s Research UK called for him to find a solution so that people with dementia in the UK don’t continue to miss out on innovative treatments, like lecanemab.
In the coming months, further negotiations between the government (the National Institute for Health and Care Excellence), the NHS and lecanemab’s manufacturer, will take place. It is up to these bodies to find solutions to the barriers currently preventing lecanemab becoming available on the NHS.
Do you need to be referred by your GP to ascertain suitability or is there a list of specialist doctors with access to the process?
Hi Tim, thank you for your comment. At the moment, because the Medicines Health Regulatory Authority (MHRA) only approved lecanemab for private use in the UK last week, it is not yet clear where it will be offered privately. There will hopefully be more information available over the coming months.
Short sighted, penny pinching, decision. Surely keeping people healthier must be a better long term benefit for society and NHS.
Hi, thanks for you comment. The National Institute for Health and Care Excellence (NICE) have to weigh up the cost of the drug to the NHS vs the benefits for people affected by dementia. Unfortunately, lecanemab has not been deemed value for money for the NHS. However, we hope that continued research will lead to treatments that can benefit people with dementia in the UK.
I welcome the regulator’s decision to exclude approval for APOE4/E4 patients, for whom the risks around Lecanemab are just too dangerous and too high. Given that those of us with 2 copies of the APOE4 gene face a very high probability of eventual Alzheimer’s, it’s important that any approved drug benefits us as well as everyone else. There is very little specific research into interventions for the APOE4/E4 population and most people have never even heard of it.
Hi Paula, thanks for your comment. As lecanemab is part of the first generation of treatments that can slow down the progression of a disease that causes dementia, we hope that future treatments will benefit more people living with dementia. As has happened with chemotherapy to treat cancer over the last few decades, treatments for diseases like Alzheimer’s will hopefully become more effective with fewer side effects as research progresses.
Can the individual part fund it instead of being denied it all together..
Hi Jennifer, thanks for your comment. Unfortunately, this wouldn’t work in the current healthcare model we have in the UK. However, scientists are working hard to find new treatments for the diseases that cause dementia which will hopefully benefit people with dementia in the future.
I think close to 1 million have dementia. How much is spent by the NHS on cancer treatments/operations/chemo/drugs for how many people?! With no question about cost?
I had cancer in my weak lungs ( Thanks To COPD). if treatment was not available I would not be writing this comment, , so I would not be so critical about the cost of such treatments. I would be the first to say YES to finding a cure for this dreadful disease, namely Alzheimer/ Dementia no matter the cost. If it was one of your loved ones I’m sure you would feel the same.