Alzheimer’s disease is relentless. It gradually affects memory, independence, and the ability to manage everyday activities. For families, the emotional toll is profound, and for care partners, the demands are often overwhelming. According to the World Health Organization, dementia is the seventh leading cause of death worldwide and one of the major causes of disability and dependency among older adults.¹ Alzheimer’s is the leading cause of dementia, responsible for up to 80 percent of cases.² With more than 771,000 Canadians living with dementia today,³ and more than 1.7 million projected by 2050,⁴ this disease is becoming one of the most significant public health challenges of our time. Yet, unlike other progressive diseases, Alzheimer’s does not receive the urgency or attention it deserves. Timely action by governments across the country is essential.

That is why Health Canada’s authorization of lecanemab in October 2025 represents a rare moment of hope. Lecanemab is the first disease modifying therapy approved in Canada that targets the underlying biology and slows cognitive and functional decline for early Alzheimer’s. 

At the Alzheimer Society of Ontario, we believe that patient choice of available treatments is critical, and access is key to enabling that choice for eligible individuals. The recent recommendation by Quebec’s Institut national d’excellence en santé et en services sociaux (INESSS) to not recommend public coverage for lecanemab is disappointing and will negatively affect access to the drug. While Health Canada recognized lecanemab’s clinical benefit, INESSS’s recommendation will create a barrier to access based on the ability to pay out of pocket or with private insurance for the drug. This is added to other barriers, such as timely diagnosis, waiting lists for specialists, and necessary community supports for individuals and families who are up against a narrow timeline when treatment can make a meaningful difference. 

The clinical evidence for disease-modifying treatments like lecanemab has been accepted in the 50 countries that approved the drug before Canada. Clinical trial data demonstrated a significant reduction in cognitive and functional decline at 18 months, helping preserve independence and quality of life.⁵˒⁶ Recently released long-term data indicate continued benefit over four years, reinforcing that early, ongoing treatment can extend time in the mild stages of the disease. In practical terms, that’s one year of delayed progression: an additional year when patients can still manage their finances, maintain their independence, and enjoy everyday moments with their loved ones.⁷˒⁸  In conversations with our clients, the message we hear at the Alzheimer Society of Ontario is consistent: “We don’t have time to wait.” Government action must reflect that urgency.

We’ve seen Canada transform care pathways before. The arrival of disease-modifying therapies to treat cancer, multiple sclerosis, and conditions such as stroke mobilized earlier diagnosis, specialized clinics, and coordinated monitoring. These changes have improved patient outcomes and quality of life. Alzheimer’s care can and must follow suit: governments must ensure access to timely diagnosis starting in primary care, ensure public reimbursement of new treatments, build MRI capacity and protocols for monitoring, and support specialized clinics to treat eligible patients. These steps are achievable, but they require political will and collaboration across the system. The time to act is now.

As lecanemab undergoes reviews along the drug reimbursement pathway, decision-makers in Canada and every province have a choice to make. To those in our communities who have followed lecanemab’s trajectory over the last two years, the choice for governments is stark: move swiftly to enable public coverage, or create massive inequities in patient access to Alzheimer’s treatment. 

We have the opportunity to make the right choice. Let’s choose to prioritize clinical benefit and value. Let’s choose to address the impact of Alzheimer’s on care partners, healthcare systems, and society. And let’s choose to do the right thing for patients and families who don’t have the luxury of time to wait.

¹ World Health Organization. Dementia: Key Facts. Available at: https://www.who.int/news-room/fact-sheets/detail/dementia.

² Alzheimer Society of Canada. What is Alzheimer’s disease?. Available at: https://alzheimer.ca/en/about-dementia/what-alzheimers-disease

³ Alzheimer Society of Canada. What is Alzheimer’s disease?. Available at: https://alzheimer.ca/en/about-dementia/what-alzheimers-disease

⁴ Alzheimer Society of Canada. Dementia numbers in Canada. Available at: https://alzheimer.ca/en/about-dementia/what-dementia/dementia-numbers-canada#Basic_facts_on_dementia

⁵ Eisai presents full results of lecanemab Phase 3 confirmatory Clarity AD study for early Alzheimer’s disease at Clinical Trials on Alzheimer’s Disease (CTAD) conference. Available at: https://www.eisai.co.jp/news/2022/news202285.html

⁶  van Dyck, H., et al. Lecanemab in Early Alzheimer’s Disease. New England Journal of Medicine. 2023;388:9-21. https://www.nejm.org/doi/full/10.1056/NEJMoa2212948 

⁷ Early Alzheimer’s Patients Continue to Benefit from Four Years of LEQEMBI® (lecanemab-irmb) Therapy New Clinical Data Presented at AAIC. News release. Biogen. July 30, 2025. Accessed December 4, 2025. https://investors.biogen.com/news-releases/news-release-details/early-alzheimers-patients-continue-benefit-four-years-leqembir 

⁸ van Dyck CH. Open-Label Extension Results of Lecanemab in Early Alzheimer’s Disease. Presented at: Alzheimer’s Association International Conference (AAIC); July 2025; Philadelphia, PA. Accessed December 5, 2025.https://static1.squarespace.com/static/5cdeb7d2d1fedc00011c178e/t/68880e562ec2e442f188d4e7/1753747031384/van+Dyck+OLE+-+2025+AAIC+-+FINAL.pdf