Use of new medications for Alzheimer’s disease in the Canadian healthcare system
Two new medications for Alzheimer’s disease are currently being considered by Health Canada. Below we share a few questions and answers about these medications to help interested Canadians learn more about them.
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Lecanemab and donanemab are new medications for Alzheimer’s disease.
These treatments can remove harmful amyloid plaques from the brain.
They do not cure Alzheimer’s disease, but they may slow it down for some people.
The effect of these medications on disease progression for people with Alzheimer’s disease has been described like this:
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Slower progression: In the first 18 months of treatment, people on these medications may decline about 27% more slowly than they would without them. -
Time saved: After treatment for 18 months, people on these medications may save about 5.3 months of maintained (extended) cognitive function compared to people who do not take the medications.
In other words, these medications may slow disease progression for people with Alzheimer’s disease, but they do not stop or reverse it. It is possible that people who take these medications may continue to do the same things they were able to do for a longer time.
Note: The two medications, lecanemab and donanemab, have both been shown to slow disease progression for people with Alzheimer’s disease. However, they have not been studied together to compare their effects. In other words, it is unclear if one is more effective than the other. Further research will help us to understand better any differences, and the long-term risks and benefits of each medication.
If a person wants to try one of these medications, a physician (doctor) needs to prescribe it. Only people at early stages of Alzheimer’s disease can receive it. The medication is injected into a vein (using an infusion/IV) every two or four weeks. It is done in a specialized clinical centre or, possibly, at a home visit. The infusion lasts for an hour.
In the trials of the treatments, approximately:
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1 in 3 people needed extra MRI brain scans because of brain swelling or bleeding;
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1 in 6 people had to skip doses of their medication because of brain swelling or bleeding;
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1 in 30 people, approximately, had symptoms from brain swelling or bleeding, including 1 in 100 who were hospitalized or had permanent effects.
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1 in 300 people had serious side effects that may have led to their death.
In some cases, the patient or the doctor decided to stop the medication because of the side effects.
Note: The two medications, lecanemab and donanemab, have been shown to have similar side effects. However, they have not been studied together to compare their effects. Further research will help us better understand differences and long-term risks and benefits of each medication.
In the United States, the cost starts at $26,500 US per year per person. The cost in Canada is not known. If one of these medications is approved, it will take several months or more before the cost in Canada is known to the public. It is currently unknown whether provincial health authorities or private health insurance companies in Canada will cover any of the cost.
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People with early-stage Alzheimer’s disease
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People who can access a medical centre with an MRI scanner, for example, because they live close enough or are able to travel there.
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It is not easy to decide if you want to take these medications. Every family may weigh the benefits and side effects differently. It is best to discuss questions and concerns about these medications with your doctor.
Note: People receiving either of these medications can have very different experiences. Some may experience no side effects and others can have severe side effects. Some may benefit and others may not. It is impossible to predict what an individual will experience.
The person
R.M. is a 70-year-old woman with mild dementia due to Alzheimer’s disease. She forgets things and needs help paying bills.
Screening
To decide if she can have the medication, she had to do a few tests. This included memory testing, an MRI brain scan, a blood test, and a lumbar puncture.
The lumbar puncture was done by a physician (doctor). The physician gave a local anesthetic and then inserted a needle in her back. The procedure hurt a little bit. It was done in a medical office and took 2 hours.
Treatment
Having the treatment meant that every two or four weeks she had to go to a clinical centre and spend half the day there. This made it hard to travel to see her children.
Additional tests
During the next 18 months, she had 4 MRI brain scans to check if there was any bleeding and swelling. No bleeding or swelling was detected. This was the best-case scenario, but it is also possible that some bleeding or swelling could have been detected, leading to mild or severe side effects. If side effects occurred, she might have needed more brain scans and could have had to stop taking the medication.
Outcome
After 18 months of treatment, it was hard to tell whether the medication helped (based on memory testing in the clinic). It didn’t improve her memory. She still forgot things. But maybe without the medication, she would have declined faster.
- The content on this page is based on this scientific review paper: Smith E. et al. (2025), Use of Lecanemab and Donanemab in the Canadian Healthcare System: Evidence, Challenges, and Areas for Future Research. Journal of Prevention of Alzheimer’s Disease. DOI 10.1016/j.tjpad.2025.100068
This page is updated from time to time as new information becomes available.
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