Alzheimer Europe has published a position paper on access to anti-amyloid therapies for Alzheimer's disease, following the authorisation of lecanemab and donanemab by the European Commission in 2025.
While these treatments are available in Japan and the USA, in most European countries they are not covered by public health systems, with the exception of provisional coverage in Austria, Germany and Luxembourg. Health Technology Assessment (HTA) bodies in Denmark, Finland, France, the Netherlands, Spain, Sweden and the United Kingdom have recommended against covering these medicines.
The uneven landscape raises equity concerns, as in the majority of European countries, access is largely confined to those who can afford to pay privately and/or travel for treatment.
Alzheimer Europe is also concerned that current HTA frameworks do not reflect the full value of these treatments, especially with regard to individual circumstances and lived experience, the significant impact of Alzheimer’s disease on informal carers, and its broader societal costs.
The organisation calls on HTA bodies to ensure that people with lived experience of Alzheimer's disease, their carers and the national patient organisations that represent them are meaningfully involved in assessments, with their contribution clearly documented in assessment outcomes.
Published data from countries where these treatments are reimbursed suggest that eligible patient numbers are considerably smaller than early projections assumed. Managed access frameworks and small-scale pilot programmes may therefore offer a practical pathway to treatment while real-world evidence continues to develop.
Investment in new treatments must be additional to, and not at the expense of, investment across the full spectrum of dementia care, which is urgently needed. Alzheimer Europe calls on governments to make dedicated and protected funding commitments across all areas of dementia support, research and care.
Luxembourg, 8 June 2026, Alzheimer Europe has today published a position paper calling for equitable and timely access to lecanemab and donanemab, the first disease-modifying therapies for Alzheimer's disease authorised in the European Union. Developed following consultation with national member associations, the European Working Group of People with Dementia (EWGPWD) and the European Dementia Carers Working Group (EDCWG), the paper sets out five areas of concern and calls for concrete action from governments, health technology assessment (HTA) bodies, manufacturers and the research community.
The European Commission's authorisation of lecanemab and donanemab in 2025 marked a significant turning point, as the first therapies able to slow the progression of Alzheimer's disease to be approved in the EU. However, in most European countries, these treatments remain inaccessible through public health systems. HTA bodies in Denmark, Finland, France, the Netherlands, Spain, Sweden and the United Kingdom have issued negative coverage recommendations. Anti-amyloid therapies are available in Austria, Germany and Luxembourg, with early coverage through hospital budgets, mainly. The recent negative benefit determination from Germany’s HTA agency may have consequences for access in that country, however. Generally, where treatment is available at all, access is typically confined to those who can pay privately, at significant cost to the patient and their family.
The position paper identifies five key concerns:
Meaningful benefit is shaped by individual circumstances and lived experience, and the significant societal cost of dementia, including the often invisible burden on informal carers, is insufficiently captured in many assessment models. The perspectives of people living with Alzheimer's disease, their carers and the patient organisations that represent them must be genuinely and substantively incorporated in assessments from the outset.
Every person with Alzheimer's disease deserves access to a timely and accurate diagnosis, independently of whether treatment is available or reimbursed. Diagnostic infrastructure gaps should not be used as a justification for withholding access to authorised therapies, and investment in diagnostic capacity is essential to prepare for future treatments.
People living with Alzheimer's disease deserve the opportunity to make an informed, supported decision on treatment with their doctors and families, based on clear and balanced information about expected benefits, risks and uncertainties.
The current absence of reimbursement across most of Europe is deepening inequity. Access is primarily determined by wealth and geography rather than clinical need, compounding disparities that extend beyond treatment to diagnosis, support and care.
Managed access frameworks and pilot programmes, of the kind already established for cancer and other serious conditions, offer a practical and proportionate pathway to treatment while real-world evidence continues to develop.
Alzheimer Europe’s position paper sets out a series of specific calls to action. HTA bodies are called on to ensure their assessments reflect the full value of these treatments, with the European Medicines Agency's benefit-risk determination as an important reference point. People with lived experience of Alzheimer's disease, their carers and the patient organisations that represent them must be meaningfully involved in all assessments from the outset, with their contribution clearly documented in the outcome.
National governments are asked to invest in the diagnostic infrastructure and specialist capacity needed to deliver these treatments safely, and to establish pathways for managed access, such as dementia drugs funds, compassionate use schemes and small-scale pilot programmes. Manufacturers are called on to engage constructively with European health systems on pricing. The organisation also calls for a pan-European approach to piloting access, enabling countries to share costs, learning and evidence.
The position paper emphasises that investment in new treatments must be additional to, and not at the expense of, investment across the full spectrum of dementia care. 12 million people in Europe are living with dementia, and many face significant difficulties in accessing post-diagnostic support, psychosocial interventions, symptomatic treatments and social care. These are longstanding, urgent needs, and Alzheimer Europe calls on governments to make dedicated and protected funding commitments across all areas of dementia care.
Commenting on the publication of the position paper, Alzheimer Europe's Executive Director, Jean Georges, stated:
" After decades without any new treatments being approved, the approvals of lecanemab and donanemab represent real progress for the Alzheimer’s disease community. However, in most European countries today, these medicines remain out of reach for the people who need them. We are calling on governments, HTA bodies and manufacturers to act, and to ensure that people with Alzheimer's disease receive the same serious consideration for access to new treatments as patients with other life-altering conditions."
Alzheimer Europe welcomed lecanemab and donanemab as the first in a new generation of disease-modifying therapies for Alzheimer's disease. The organisation recognises, however, that the therapies are indicated for a narrowly defined group of patients in the early stages of Alzheimer's disease, that disease progression is slowed but not halted, and that treatment carries significant side effects requiring careful monitoring. Alzheimer Europe hopes that anti-amyloid therapies will act as a catalyst, opening the door to a more diverse and accessible therapeutic landscape while driving systemic improvements in diagnosis, care and patient pathways which are long overdue. Alzheimer Europe remains committed to a holistic approach to dementia, where innovative treatments go hand in hand with counselling, support and adequate care of people with dementia and their carers throughout the disease process.
You can download the position paper, here: https://www.alzheimer-europe.org/policy/positions/alzheimer-europe-position-access-anti-amyloid-treatments-europe-0
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Declaration of interests: Alzheimer Europe had an audited income of EUR 3,142,316 in 2025. Sponsorship by the developing companies of lecanemab and donanemab in 2025 amounted to EUR 90,000 (Lilly), EUR 37,500 (Biogen) and EUR 35,000 (Lilly) or 5.17% of the organisation’s income in 2025. Sponsorship by pharmaceutical companies is only accepted in accordance with the organisation’s Sponsorship guidelines and, in line with the European Medicines Agency criteria for patient organisations, declared in full transparency on the Alzheimer Europe website: https://www.alzheimer-europe.org/about-us/governance/finances/alzheimer…
