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Public drug plans should not cover lecanemab, a drug to slow early-stage Alzheimer’s disease, Canada’s Drug Agency said Thursday in a draft recommendation.
Lecanemab is a lab-made antibody given by intravenous infusion twice a month. It targets the buildup of amyloid plaque in the brain, a hallmark of Alzheimer’s disease. The drug is not a cure and cannot reverse the disease or restore lost memories.
An estimated 772,000 Canadians have dementia, which slowly damages memory and thinking skills. Alzheimer’s is the most common form of dementia.
In October 2025, Health Canada announced it conditionally approved the drug. At the time, the Alzheimer’s Society of Canada called it the first disease-modifying Alzheimer’s treatment approved for use in the country and is keeping people at mild stages of the disease longer. Current medications mitigate symptoms rather than change the course of the disease.
The drug company’s clinical trial that led to the drug’s approval in more than 50 countries found it slowed the rate of cognitive and functional decline by 27 per cent compared with a placebo over 18 months.
Dr. Howard Chertkow, scientific director of the consortium and a senior scientist at Baycrest Health Sciences Centre in Toronto, has likened lecanemab’s improvements to a first-base hit, rather than a home run.
“This will be difficult news for many individuals and families affected by Alzheimer’s disease, despite this not being the final recommendation,” the Alzheimer’s Society of Canada said in a statement on its website.
The decision from Canada’s Drug Agency will be open for feedback until March 5 before a final recommendation.
The Fédération québécoise des Sociétés Alzheimer has launched a bilingual website to help identify the early signs of Alzheimer’s disease.
Drug rejected by other agencies
The submitted treatment cost amounted to nearly $30,000 per year, depending on a patient’s weight, according to the agency.
Patients must have a documented presence of amyloid plaque in the brain, the drug company Eisai said.
Patients must also seek testing for gene variants associated with negative side-effects, which can include rare but serious microbleeds and swelling in the brain. The new treatment is only available for patients with a single or no copy of a gene variant called APOE4.
In December 2025, Quebec’s counterpart drug agency, rejected listing lecanemab.
In 2024, Britain’s National Institute for Health and Care Excellence (NICE) concluded the benefits of lecanemab are too small to justify the cost to the publicly-funded health system of providing the treatment, including giving the medication and monitoring for side-effects.
Anyone taking the drug needs ongoing monitoring, typically with PET scans or MRIs, to ensure safety and effectiveness.
