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 through intravenous infusion, is designed to target the accumulation of amyloid plaque in the brain, a characteristic feature of Alzheimer’s disease.
While lecanemab is not a cure and cannot reverse the disease or restore lost memories, it marks a significant advancement as the first disease-modifying Alzheimer’s treatment approved for use in the country. Unlike current medications that primarily alleviate symptoms, lecanemab aims to alter the disease’s progression.
The drug’s effectiveness and potential implications for Canada’s healthcare systems are now key considerations for individuals with Alzheimer’s disease, their families, healthcare providers, and policymakers.
Lecanemab, also known as Leqembi, is approved to treat mild cognitive impairment and the 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 adverse effects. The treatment is specifically recommended for patients with one or no copies of the APOE4 gene variant, as those with two copies are at higher risk of brain swelling or bleeding.
Access to the necessary genetic testing may vary across different provinces and territories in Canada. While the drug shows promise, concerns remain about its cost-effectiveness and impact on patients’ independence. More research is needed to determine if the benefits of lecanemab justify its price tag and practicality for widespread prescription.
To be eligible for lecanemab, individuals require specialized diagnostics such as a lumbar puncture or amyloid PET scan. The drug is administered every two weeks via intravenous infusion, with each session lasting approximately an hour. Ongoing monitoring through imaging scans like PET scans or MRIs is essential to ensure the treatment’s safety and efficacy.
Potential side effects highlighted by the Canadian Consortium on Neurodegeneration in Aging include brain swelling or bleeding, which were observed in clinical trials involving lecanemab. While the drug represents a significant step forward, it is likened to a preliminary achievement rather than a definitive solution. The impact of lecanemab may vary among different demographic groups, emphasizing the need for further research to identify those who would benefit most from the medication.
The Alzheimer’s Society advocates for swift regulatory approval and public funding of lecanemab to make it accessible to all eligible patients in Canada. The drug’s current cost of approximately $26,000 US per year in other countries underscores the importance of ensuring affordability and equal access to innovative treatments.
While it typically takes up to two years for new medications to be publicly covered after regulatory approval, private or extended benefits may offer earlier access. The considerations surrounding the cost-benefit ratio of lecanemab echo discussions in other countries, such as Britain, where the National Institute for Health and Care Excellence (NICE) deemed the treatment’s benefits insufficient to justify its public funding.
