Money Rules: Can Health Systems Afford New Alzheimer’s Drugs?

A new analysis from Trinity College Dublin, published May 13, 2026, in *Alzheimer’s & Dementia*, reveals that lecanemab and donanemab—two drugs offering the first disease-modifying benefits for early Alzheimer’s—may be financially inaccessible to most health systems worldwide. The study, covering 174 countries, found neither drug would be cost-effective at current prices, with US market prices exceeding value-based thresholds by 182% for lecanemab and 129% for donanemab. Researchers used a simulation model to compare lifetime outcomes for early Alzheimer’s patients receiving these treatments alongside standard care. While the drugs could slow disease progression, their high costs, frequent infusions, and monitoring requirements strain budgets, particularly in low- and middle-income countries where cost-effectiveness data is often lacking. The findings highlight a global equity issue: prices deemed acceptable in high-income markets like the US are far above what would be considered fair value elsewhere. Without tailored pricing, patients in many regions may face delays or no access despite clinical benefits. Dominic Trépel, PhD, the study’s lead investigator, warned that pricing—not just clinical efficacy—will determine real-world access. The analysis underscores the need for differentiated pricing models to ensure equitable distribution of these breakthrough therapies. Alzheimer’s remains a growing global health challenge, and the study suggests current pricing strategies may limit the impact of these long-awaited treatments.