Scotland Says No To Second Alzheimer’s Drug, Donanemab

People with early-stage Alzheimer’s disease in Scotland will not be able to access the drug donanemab on the NHS, after it was rejected for use by the Scottish Medicines Consortium (SMC).

The decision follows the SMC’s rejection of another similar Alzheimer’s drug, lecanemab, earlier this year. These decisions follow that of the National Institute for Health and Care Excellence, which last year provisionally ruled that both donanemab and lecanemab should not be made available on the NHS for people in England and Wales.

Donanemab is not a cure. But clinical trials show it can slow the progression of early-stage Alzheimer’s by around a third. It works by targeting a protein called amyloid, which builds up in the brains of people with Alzheimer’s.

The SMC said evidence put forward for how well the drug works, as well as how much it would cost to be delivered by the Scottish NHS, was not strong enough.

In the US, donanemab infusions are estimated to cost around $32,000 per year, along with extra costs for scans and medical care. For now, because of decisions like the one from SMC, the medicine can only be accessed privately in the UK – putting it out of reach for many families.

David Thomas, Head of Policy and Public Affairs at Alzheimer’s Research UK, said the announcement was another disappointment for people in Scotland. There are currently more than 90,000 people living with dementia in Scotland, and more than half of them have Alzheimer’s disease.

“No one should be priced out of the chance to slow down Alzheimer’s,” he said.

Find out more about donanemab, including how it works and who it’s for, here.

The makers of these new medicines are working on alternative ways to administer the treatments. In January, the drug company that makes lecanemab asked the US medicines regulator to approve a version that people could inject themselves at home, rather than attend hospital for an infusion. A decision is expected by the end of August 2025.

But Alzheimer’s Research UK says the UK “cannot afford to sit and wait.” The charity is calling for pilot studies across all four UK nations to better understand how these new drugs work in practice – including the best course of treatment, how they affect people long-term and what resourcing hospitals and dementia services will need so these medicines – or the next generation of treatments – can be quickly rolled out across the NHS in the future.

“Governments from across the four nations, regulators, the NHS and industry must now urgently come together to create a plan to fast-track access to new treatments, so that people with Alzheimer’s aren’t left behind,” he said.