Alzheimer's Drug Lecanemab Too Costly for NHS

The National Institute for Health and Care Excellence (NICE) has decided not to approve lecanemab, the first drug shown to slow the progression of early-stage Alzheimer’s, for use on the NHS in England. NICE concluded that the benefits of the drug, which demonstrated a 25% reduction in cognitive decline over 18 months in clinical trials, do not justify the associated costs. The treatment requires intensive monitoring and frequent hospital visits, adding to the financial burden. David Thomas, head of policy at Alzheimer’s Research UK, expressed disappointment at NICE's decision, calling it a "bittersweet moment." He noted that approximately 70,000 adults in England would have qualified for lecanemab treatment. The implications of this decision may extend to Wales and Northern Ireland, which typically align their medical guidance with England. Meanwhile, Scotland's assessment body has yet to announce its stance on the drug. Although the UK’s Medicines and Healthcare products Regulatory Agency (MHRA) has approved lecanemab, it has imposed restrictions due to potential side effects, particularly for individuals with the APOE4 gene variant. The European Medicines Agency (EMA) recently rejected the drug's license, citing that the benefits do not outweigh the risks of serious side effects, including brain swelling and bleeding. Diagnostic methods necessary for monitoring patients receiving lecanemab, such as PET scans and lumbar punctures, are not standard practice for dementia diagnosis, limiting access to only about 2% of Alzheimer’s patients.