London |The National Health Service will not fund two new Alzheimer’s drugs after an official review concluded the treatments cost too much and offer too little benefit.
The National Institute for Health and Care Excellence (NICE) announced that donanemab and lecanemab two drugs that slow cognitive decline in early Alzheimer’s do not meet the standards for cost-effectiveness. The decision, based on extensive review, may impact up to 70,000 people with mild dementia in England who would have qualified for treatment.
“These drugs deliver only modest benefits and would require major resources to implement,” said Helen Knight, director of medicines evaluation at NICE. “Funding them could mean cutting back on other critical NHS services.”
Donanemab and lecanemab work by targeting and clearing a sticky brain protein linked to Alzheimer’s disease. Trials showed that they slow the decline in memory and thinking. However, the drugs do not stop or reverse the disease.
Patients in clinical trials experienced a delay of four to six months in progression from mild to moderate dementia. This could allow more time for patients to live independently, drive, or engage with family. Still, NICE said the benefits were too slight to justify the price.
In U.S. markets, the drugs carry an annual price tag between £20,000 and £25,000 per patient. The NHS has not disclosed the negotiated price. However, estimates place the total cost around £1.5 billion per year for the drugs alone without accounting for ongoing brain scans, monitoring for side effects, or infusion costs.
Prof. Rob Howard analyzed the clinical data and said the improvements were barely perceptible. “In the lecanemab trial, patients improved by just 0.45 points on an 18-point dementia scale,” he explained. “It’s a marginal change, and the cost per patient would rival a nurse’s annual salary.”
NICE made a similar finding last year and gave drugmakers three weeks to appeal before a final decision on July 23. Both pharmaceutical firms involved Eisai, which developed lecanemab, and Eli Lilly, the maker of donanemab have stated they intend to challenge the ruling.
Nick Burgin of Eisai said the rejection reflects more than cost. “Even if we gave lecanemab to the NHS for free, it would still be denied,” he claimed. “The NHS isn’t prepared for Alzheimer’s care.”
Chris Stokes of Eli Lilly criticized the health system directly. “If the system can’t deliver scientific firsts to patients, it’s broken,” he said.
Alzheimer’s charities expressed deep disappointment. Prof. Fiona Carragher of the Alzheimer’s Society said, “Science is moving fast, but the system is standing still. These decisions hurt families.”
Hilary Evans-Newton from Alzheimer’s Research UK called the verdict “painful,” arguing that patients are being left behind “not because science is failing, but because the system is.”
Still, other experts backed NICE’s conclusion. Prof. Tom Dening from the University of Nottingham said the real challenge lies in improving care, not chasing expensive treatments with minimal results. “Providing structured activities and daily support already makes a real difference,” he said. “That’s where the investment should go.”
Prof. Atticus Hainsworth echoed the point. “NICE is following evidence, not emotion,” he said.
Despite the setback, Alzheimer’s research continues. As of this month, 138 dementia drugs are being tested in 182 trials worldwide.
Prof. Tara Spires-Jones of the University of Edinburgh said there is reason to stay hopeful. “We are likely to see better, safer treatments emerge soon,” she said.
For now, NHS patients must wait as appeals proceed and new studies look to prove that the next wave of drugs can deliver more value without overwhelming the health system.
