Scotland Says No to Alzheimer’s Drug lecanemab

The Scottish Medicines Consortium (SMC) has rejected a new Alzheimer’s drug, lecanemab (sold under the brand name Leqembi), for use on the NHS in Scotland. The SMC said there were uncertainties about the health benefits of lecanemab set against its costs, including monthly infusions and regular monitoring for side effects.

This comes six months after the drug was also rejected by the National Institute for Health and Care Excellence (NICE) for use on the NHS in England and Wales. As a result, anyone eligible for lecanemab and wishing to receive it will need to pay for it privately.

After announcing its decision, the SMC said it would “welcome a resubmission from the company with changes to address the uncertainties”.

Charities described the decision as a heartbreaking setback. The drug’s steep price tag puts it out of reach for many families already bearing the financial and emotional burden of care, with some even giving up their careers to support loved ones.

Hilary Evans-Newton, Chief Executive of Alzheimer’s Research UK, called on the government to use this decision as a wake-up call, stressing that the upcoming 10-Year Plan for Health must consider people affected by dementia, and help shape a future where it no longer devastates lives and the NHS.

“Without action, the NHS risks progressively falling further behind Europe, America and Asia when it comes to access to new, innovative dementia treatments – many more of which are on the horizon,” she said.

There are currently over 160 trials worldwide testing more than 125 experimental Alzheimer’s treatments. Of these, 30 are in late-stage trials that NHS England has identified as potential treatments available by 2030.

Like similar decisions in England and Wales, today’s outcome is largely driven by the costs of expanding diagnostic infrastructure, such as brain scans, and administering infusions. Evans-Newton highlighted potential solutions to address these challenges.

“One promising option would be moving from hospital infusions to injections at home — something already being explored in clinical trials and under review by the FDA in the US. But this won’t happen quickly, so it’s vital for the UK government, NHS leaders, and industry to come together and find innovative approaches to ensure people can benefit from new Alzheimer’s treatments now.”