Canada's Drug Agency Recommends Against Public Coverage for Alzheimer's Drug Lecanemab
Canada's Drug Agency issued a draft recommendation against public drug plan coverage for lecanemab, an Alzheimer's treatment conditionally approved by Health Canada in October 2025, citing cost concerns despite the drug's ability to slow cognitive decline.
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. The decision will be open for feedback until March 5 before a final recommendation.
Lecanemab, which is sold under the brand name Leqembi, costs nearly $30,000 a year for the average patient. Health Canada approved the drug in October 2025 under conditional approval. The drug is approved to treat mild cognitive impairment and early Alzheimer's.
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.
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. Lecanemab represents the first fully FDA-approved disease-modifying therapy identified in two decades.
An estimated 772,000 Canadians have dementia, which slowly damages memory and thinking skills. Alzheimer's is the most common form of dementia.
Patients must have a documented presence of amyloid plaque in the brain. 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.
Anyone taking the drug needs ongoing monitoring, typically with PET scans or MRIs, to ensure safety and effectiveness.
In December 2025, Quebec's counterpart drug agency rejected listing lecanemab. In 2024, Britain's National Institute for Health and Care Excellence 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.
A total of 10 therapeutic drugs has been approved by the FDA or other drug regulatory agencies by 15 August 2025. Among them, 9 were approved by the FDA, and 1 was approved in China. Notably, 40% of all launched AD drugs were approved after 2020, marking the transition from a long dormant phase to rapid growth.