Canada’s Drug Agency has released a draft recommendation for donanemab funding

The Alzheimer Society of BC and Yukon, alongside the Canadian Federation of Alzheimer Societies, welcomes the draft recommendation from Canada’s Drug Agency (CDA) which suggests that donanemab (Kisunla^TM) be eligible for reimbursement. This marks an important step toward expanding treatment options for people living with early-stage Alzheimer’s disease.

“This recommendation is an important step in the right direction,” says Cathryn France, Interim CEO of the Alzheimer Society of BC and Yukon. “The approval of treatments like donanemab offers hope to people affected by the disease, but approval alone is not enough. We need to ensure that people across British Columbia and Yukon have equitable access to timely diagnosis, appropriate monitoring and the practical supports needed to determine whether these treatments are right for them. As new treatment options become available, we will continue to advocate for health systems that allow eligible people to make informed decisions about their care and access treatment without unnecessary barriers.”

Clinical studies show that donanemab can help slow decline in memory, thinking and daily activities for people with mild cognitive impairment or mild dementia due to Alzheimer’s disease. However, donanemab is not a cure and will not be appropriate for everyone living with Alzheimer’s disease, including people with moderate or severe Alzheimer’s disease and people who carry two copies of the APOe4 gene.

This draft recommendation marks another development in Canada’s evolving Alzheimer’s disease treatment landscape; however, it does not mean that donanemab will be immediately reimbursed for people who are eligible. Next, provinces and territories will decide whether they will cover the drug, based on the CDA’s recommendation. Private insurers will also consider whether to fund the medication.

Once these decisions have been made, the availability of disease modifying therapies will be dependent the health-care system readiness to support a timely diagnosis and eligibility screening, monitoring and follow-up care. For donanemab specifically, this includes access to regular MRI scans to monitor for potential side effects, as well as the clinical infrastructure needed to deliver regular infusions. Preparing the health-care system for disease-modifying therapies, like lecanemab and donanemab will require investment in health human resources, infrastructure, training and new care pathways so that treatment can be delivered safely and equitably. Regardless of whether or not someone chooses to pursue disease-modifying therapies, people will continue to need support. Continued investment in community programs and services is also essential to ensure people affected by dementia receive the appropriate care and support they need to manage as well as possible.

Likewise, access to specialists, diagnostic tools and infusion services varies significantly across Canada. As provinces and territories consider implementation, efforts should be made to reduce geographic and financial barriers so that access is determined by clinical need and informed choice.

With our federation partners, we will continue to advocate for equitable access, informed decision-making and health-system readiness so that scientific progress leads to real-world benefit for people living with dementia and care partners. We will also continue to call for greater investment in public education on risk reduction, system navigation and the community supports that are essential across the dementia care continuum in Canada.

While emerging therapies bring tremendous hope to our community, we know that people living with dementia and the people who support them also need help today.