Canadian drug agency recommends public funding for Alzheimer's disease treatment

Canada's Drug Agency is recommending that public drug plans pay for lecanemab, a treatment shown to slow the progression of early-stage Alzheimer's disease, marking a significant reversal from its February recommendation against public coverage.

Lecanemab is an antibody that targets the buildup of amyloid plaque in the brain, believed to be an underlying cause of Alzheimer's disease. Health Canada approved it last October, but the drug agency initially recommended against publicly funding it due to concerns about effectiveness and possible side effects including brain swelling or bleeding.

After reconsidering at the request of the drug's manufacturer, Eisai, the agency's expert committee found it may have underestimated lecanemab's clinical meaningfulness. In the updated recommendation released Thursday, the drug agency says it recognizes patients with early Alzheimer's disease are faced with a progressive and ultimately debilitating condition for which there are limited treatment options.

The agency says eligible patients must have only mild cognitive impairment, have amyloid protein confirmed by a brain scan or cerebrospinal fluid analysis, and get regular MRIs to check for any signs of brain swelling or bleeding. If a patient's condition worsens from mild to moderate dementia, the drug should no longer be covered. Studies have only shown lecanemab to be effective in early-stage Alzheimer's disease.

Alzheimer's societies in Canada have been urging the drug agency and provincial governments to publicly fund lecanemab, also known by its brand name Leqembi. They say the drug can extend the period of better cognitive function and give patients more quality time with loved ones before their dementia progresses. According to the Canadian Consortium on Neurodegeneration in Aging, lecanemab costs about $32,000 per year.