A Message from our CEO: Health Canada's Approval of Lecanemab

Health Canada’s approval of lecanemab marks an important moment for Alzheimer’s disease in Canada. It’s the first disease-modifying treatment to be approved for Alzheimer’s disease, targeting the underlying biology of the disease. It’s a breakthrough that brings long-awaited hope, but that hope is not without concerns. 

Lecanemab offers modest benefits for people in early stages of Alzheimer’s disease or with mild cognitive impairment. Those in later stages of Alzheimer’s disease, or with other forms of dementia, will not be eligible for this drug.

Carriers of the APOE4 gene or heterozygotes will also not be eligible for this drug. Health Canada’s decision to place this limit acknowledges the higher potential risk of serious side effects among people who are carriers of the APOE4 gene. Research shows that this group faces a much higher risk of brain swelling and small brain bleeds when taking the medication. 

While this restriction aligns with international standards, it means more Canadians will need genetic testing to find out if they’re eligible for treatment. Unfortunately, access to this testing varies across provinces and territories, which could delay treatment access for some people.

Health Canada’s approval is only the first step. Canada's Drug Agency (CDA-AMC) must assess whether lecanemab should be publicly reimbursed, and then the provinces and territories will determine whether their health system will cover it. 

This is a process that can take years, time that people living with this progressive disease simply don’t have. For many, the window for treatment will close before policy decisions are made. Those with extended healthcare benefits may be covered sooner, depending on their insurer, but pricing of the drug in Canada has not been determined yet.  
Access to this treatment will require early and accurate diagnosis, something we know many Nova Scotians struggle to access. It also requires specialized imaging and trained clinical teams capable of safely delivering and monitoring the drug, which must be administered intravenously in a clinical setting.

Across Canada, these healthcare resources are not equally available and, in too many communities, they’re out of reach entirely. In Nova Scotia, these inequities could be even more pronounced. With one of the oldest populations in the country, a large rural footprint, and thousands of people without access to primary care, the very infrastructure needed to deliver this treatment from diagnosis to follow-up, is already under immense strain. For rural and underserved communities, the promise of a new Alzheimer’s therapy may feel distant, if not unreachable.

Without equitable access to the healthcare resources necessary to receive this treatment, lecanemab risks becoming another example of medical innovation that serves the few rather than the many.

If access to lecanemab depends on where you live, what healthcare services you have access to, or whether you have private insurance, then we have failed the very people this treatment was meant to help. We need investment in diagnostic capacity, clinical readiness, and coordinated planning that bridges the gap between approval and availability.

This approval is a milestone, but also a mirror. It shows where our health systems shine and where they fall short. We hope that this milestone will continue to inspire more research advancements to identify further treatment options for Alzheimer’s disease, and for other types of dementia.

The Alzheimer Society of Nova Scotia will continue to advocate for a future where advances in research reach everyone, not just those who can afford to access them. Because every Nova Scotian living with dementia deserves more than hope.

We’ll follow up with a question-and-answer post to provide more information about lecanemab. If you have a question, please submit it below by November 2, 2025, and we will do our best to answer questions with the information currently available.

 

Media Contact:
Jenna Corcoran
[email protected]
902-332-0979