On 10 February, the Scottish Medicines Consortium (SMC), which advises on newly licensed medicines for use by NHS Scotland, announced its decision to reject lecanemab for the treatment of early Alzheimer’s disease (AD). While lecanemab has been approved in multiple countries (i.e. the US, Japan, China, South Korea, Hong Kong, Israel, Great Britain and Europe), the SMC concluded that the available evidence did not demonstrate sufficient clinical benefits to justify its high cost within the NHS budget.
“SMC welcomed the submission for lecanamab and recognises the need for new therapies for Alzheimer’s disease. Having considered all the evidence, we were unable to accept lecanamab for treatment in the NHS in Scotland. The committee felt that there remains uncertainty around what the modest clinical benefit means for patients and their families and, in addition, the cost-effective estimates supplied by the company were too high.” said SMC Chair Dr Scott Muir.
Lecanemab, developed by pharmaceutical companies Eisai and Biogen, is a disease-modifying drug used in the treatment of early AD (mild cognitive impairment and mild dementia due to Alzheimer's disease). The drug works by using the body's immune system to reduce the build-up of amyloid proteins in the brain, which are associated with the disease. Despite the approval of lecanemab by the UK Medicines and Healthcare products Regulatory Agency (MHRA), the SMC's decision aligns with that of the National Institute for Health and Care Excellence (NICE), which rejected lecanemab for use on the NHS in England and Wales six months ago.
Alzheimer Scotland expressed disappointment with the SMC's decision. Henry Simmons, Chief Executive of Alzheimer Scotland, stated: “We know this decision by the SMC will be disappointing for many people. This remains the first new drug shown to slow down the progression of Alzheimer’s disease, rather than simply treating the symptoms. We remain optimistic that these initial hurdles will be overcome and, after decades of waiting, that new treatments will be approved for NHS use soon.” After announcing its decision, the SMC said it would “welcome a resubmission from the company with changes to address the uncertainties”.
For more information, you can access the SMC's decision news release here: https://scottishmedicines.org.uk/about-us/latest-update/february-2025-decisions-news-release/
Read the Alzheimer Scotland’s response here: https://www.alzscot.org/news/our-response-to-the-scottish-medicines-consortiums-assessment-of-lecanemab