On 22 August, the Medicines and Healthcare products Regulatory Agency (MHRA) approved the sale of Lecanemab for the early stages of Alzheimer’s disease in the UK. This is a landmark event in the development of a potentially disease-modifying treatment for the leading cause of death in England and Wales. A report recently published by the Alzheimer’s Society found that approximately a million people in the UK are currently living with dementia and this is projected to rise to 1.4 million people by 2040.
At this stage NICE has not recommended that Lecanemab be made available for NHS use in England or Wales, citing modest benefits with the potential for significant side effects. Despite the decision by NICE to not make this medication available through the NHS, this is a significant step in the field of Alzheimer’s disease research. There are now more than 160 international trials underway testing over 100 novel therapies for this disease.
Public excitement that new therapies are being developed should not distract from the immense challenges faced by the UK’s health and social care system, caring for people living with cognitive impairment due to Alzheimer’s disease and related conditions. Around 1 in 3 people with dementia never receive a formal diagnosis. The provision of diagnostic services, post-diagnostic support, and specialist care for complex mental and physical health and social problems remains a ‘postcode lottery’. There must be more investment in healthcare provision and innovative scientific research to improve dementia care.
This announcement regarding Lecanemab’s approval for use in the UK should provide a catalyst for practical systemic changes to improve access to timely and accurate dementia diagnosis through services attuned to older people’s needs and person-centred at every stage of progression, from pre-diagnosis to end of life care.
