A groundbreaking new drug has just entered the fray against Alzheimer’s disease, but here’s where it gets controversial: is lecanemab (marketed as Leqembi) truly a game-changer—or just another costly gamble? Let’s break this down.
Dementia, now the leading cause of death in Australia, affects millions globally, with Alzheimer’s disease alone accounting for 60–80% of all cases. Imagine a world where early intervention could slow this devastating condition. That’s the promise of lecanemab, a monoclonal antibody recently approved by Australia’s Therapeutic Goods Administration (TGA). But with a price tag of roughly $40,000 per year and serious side effects, the debate over its real-world value is heating up.
How Does It Work?
Monoclonal antibodies are lab-engineered proteins designed to target specific molecules in the body. In lecanemab’s case, the target is amyloid—a protein that clumps in the brains of people with Alzheimer’s, forming toxic plaques. Think of lecanemab as a molecular magnet, binding to these amyloid plaques and signaling the immune system to sweep them away. This process aims to reduce ongoing damage to brain cells, potentially slowing cognitive decline.
Does It Actually Work?
Clinical trials involving 1,734 participants showed promising results. Over 18 months, those receiving lecanemab experienced a 27% slower decline in cognitive and functional abilities compared to a placebo group. To put that into perspective, this translated to about five months’ less deterioration during the trial period. Long-term data now suggests this benefit could extend up to four years for some patients. However, here’s the catch: the drug doesn’t reverse symptoms. It only delays their progression.
The Cost of Progress
But this progress comes at a steep price. Lecanemab isn’t subsidized by Australia’s Pharmaceutical Benefits Scheme (PBS), meaning patients must pay out-of-pocket. That’s $40,000 annually—plus the cost of regular MRI and PET scans to monitor side effects. For comparison, a similar drug, donanemab, was recently rejected for PBS listing due to concerns that its benefits were “too small and uncertain” to justify the financial and health burdens.
Risk vs. Reward
No drug is without risks, and lecanemab is no exception. Brain swelling (affecting 12.6% of trial participants) and microbleeds (17.3% of users) are serious concerns. While most cases of swelling were asymptomatic, 22% of those affected reported headaches, dizziness, or balance issues. A small number of patients on blood-thinning medications even experienced fatal brain bleeds. To mitigate these risks, ongoing MRI monitoring is required—a costly and time-consuming process.
Who Should Consider This Drug?
Lecanemab is only suitable for individuals in the earliest stages of Alzheimer’s. If you or a loved one is noticing persistent memory lapses, confusion about time, or difficulty with familiar tasks, early diagnosis is critical. But here’s the part most people miss: this drug isn’t a cure. It won’t restore lost memories or halt the disease entirely. It simply buys time—time that may come at a significant personal and financial cost.
The Bigger Picture
So, is lecanemab a breakthrough or a burden? Critics argue that its high cost and side effects may outweigh its modest benefits, especially for those with limited resources. Supporters, however, see it as a beacon of hope in a field desperately lacking effective treatments. What’s your take? Do the potential benefits justify the risks and costs? Share your thoughts in the comments—this is a debate that’s far from settled.
