The therapy could reach public drug plans after a $50,000 price stalled it elsewhere
A therapy that can run about $50,000 over 18 months of infusions could move toward Canada's public drug plans for people in the early stages of Alzheimer's disease.
Canada's Drug Agency issued a draft positive recommendation on July 16 for public reimbursement of lecanemab, sold as Leqembi, for eligible patients with mild cognitive impairment or early-stage Alzheimer's disease, according to the agency.
The draft marks a shift.
In February 2026, an Ontario ministry of health spokesperson said cited by CTV News, the agency had issued a do-not-reimburse recommendation for lecanemab in adults with a clinical diagnosis of mild cognitive impairment or mild dementia due to the disease.
Alzheimer Europe reported that Canada's Drug Agency revised its draft to a positive reimbursement recommendation, though the July decision is not yet final.
That earlier rejection had put Canada alongside several public payers weighing the drug's price against modest gains.
Lecanemab has won approval in roughly 53 countries and regions, including the United States, Japan, China, Europe, South Korea and the UK, per Biogen, but public coverage varies sharply.
The United States and Japan reimburse it under public health insurance, according to a 2025 study in Alzheimer's & Dementia, which counted about 6,000 patients treated in Japan in the first year after approval.
The UK offers the closest parallel to Canada's original stance.
Britain's Medicines and Healthcare products Regulatory Agency licensed the drug in August 2024, yet the National Institute for Health and Care Excellence rejected it for routine NHS use in England and Wales, finding the benefits too small to justify the cost.
NICE calculated that the cost per quality-adjusted life year far exceeded the thresholds it treats as acceptable, and reviewers found the therapy delayed progression from mild cognitive impairment to moderate Alzheimer's by about four to six months.
UK patients can now get it only by paying privately.
Regulators elsewhere split further: a pharmacovigilance review notes that the European Medicines Agency refused approval in July 2024, then reversed course that November with use limited to patients carrying one or no copy of the ApoE ε4 gene, while Australia's regulator refused approval in October 2024.
Public drug plans across Canada will next decide whether to fund the treatment.
Drugs recommended for funding go to negotiation among the provinces and territories through the pan-Canadian Pharmaceutical Alliance, the Ontario spokesperson said, with any final decision resting on expert committee advice, the outcome of those negotiations, program sustainability and the public interest.
Cost stays a barrier for patients outside clinical trials.
Lecanemab is an infusion that targets amyloid proteins in the brain associated with Alzheimer's, and it is the first Health Canada-approved treatment shown to slow the disease's progression in its earliest stages, Michael Borrie, a London geriatrician who has taken part in Canadian clinical trials of the therapy, told CTV News.
Trial data shows it can slow cognitive decline and help patients keep their independence longer, he said.
Borrie supported the draft and said it gives hope to people in the early stages of dementia.
He works at St Joseph's Hospital in London and formerly led the Consortium of Canadian Centres for Clinical Cognitive Research.
The Alzheimer Society of Canada also welcomed the draft, saying public reimbursement could help make the therapy available to eligible Canadians living with mild cognitive impairment and early-stage Alzheimer's.
The society noted the recommendation is not final.
Ontario reviews drug funding through an evidence-based process and has committed more than $4.1m to expand complex care supports, including enhanced Alzheimer's and dementia services, according to the spokesperson, who also pointed to the Improving Dementia Care in Ontario Act, 2024.
