As clinicians working in dementia care across Ireland, we have written to the Minister for Health to express our deep concern about the recent recommendation by the National Centre for Pharmacoeconomics (NCPE) against public reimbursement of lecanemab, the first disease-modifying treatment for Alzheimer’s disease licensed in Europe.
For the first time, there are treatments that can slow the progression of Alzheimer’s disease, offering patients and families valuable additional time with greater independence and quality-of-life. While these treatments are not a cure, they represent a fundamental shift in what patients can access.
We are deeply concerned that Ireland risks being left behind as these advances become available internationally and that, without a publicly funded pathway, patients with the same clinical needs may face unequal opportunities to access treatment, undermining the principle of equitable healthcare.
We fully recognise the importance of responsible healthcare spending, but believe there is an urgent need to explore practical solutions, including managed access arrangements. The decisions made now will shape whether people living with Alzheimer’s disease in Ireland can benefit equitably from this and future generations of treatment.
What are these new treatments?
Two new treatments for Alzheimer’s disease, lecanemab (Leqembi) and donanemab (Kisunla), have recently been approved for use in Europe. Both work by removing amyloid, a protein that builds up in the brain in Alzheimer’s disease.
Clinical trials have shown that these treatments can slow the worsening of memory, thinking and everyday abilities by around 20–40 per cent over 18 months, depending on how this is measured. These are modest benefits, and neither treatment is a cure. However, for people living with Alzheimer’s disease and their families, even a small delay in progression may mean valuable additional time living independently and with fewer symptoms. Both treatments carry risks and require careful assessment and monitoring.
What is happening in the UK?
As our nearest neighbour, the UK often provides a useful comparator for evaluating the introduction of new medicines and healthcare innovations, including treatments for Alzheimer’s disease.
In the UK, there is growing pressure to find a way forward on access to new Alzheimer’s treatments. Both lecanemab and donanemab have received regulatory approval, but NICE recommended against routine NHS funding in June 2025 on cost-effectiveness grounds. Following appeals by both manufacturers, NICE upheld some grounds for appeal and is reconsidering its recommendations, with revised decisions still awaited. Our counterparts in the UK are also calling for negotiations between NHS England and the manufacturers to explore options for patient access.
Alongside this, the UK government has announced a £48 million partnership to accelerate dementia research and clinical trials, reflecting a wider commitment to advancing dementia care. Alzheimer’s Research UK has also called for a dedicated Dementia Drugs Fund, similar to the Cancer Drugs Fund, which would enable carefully managed access to new treatments while further evidence is gathered on their benefits, safety, and costs.
Together, these developments highlight the importance of exploring practical solutions that balance responsible healthcare spending with equitable access to new treatments for patients and families.
- Last month Dublin hosted leading dementia clinicians, researchers and advocates from across Europe at the Alzheimer Europe Conference (27–29 October). Against this backdrop, the NCPE recommendation raises important questions about Ireland’s readiness to translate advances in Alzheimer’s research into meaningful treatment opportunities for patients.
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