The Netherlands’ National Healthcare Institute (Zorginstituut) has advised against including the Alzheimer’s drug lecanemab (marketed as Leqembi®) in the country’s basic health insurance package, citing limited clinical benefit and the risk of serious side effects. The recommendation, issued on February 18, 2026, marks a setback for patients and advocates who had hoped the medication would offer a novel treatment option for early-stage Alzheimer’s disease.
Lecanemab, designed to slow the progression of Alzheimer’s by clearing amyloid plaques in the brain, received conditional marketing authorization from the European Commission last year. Though, the Zorginstituut’s assessment concluded that the drug’s modest effect on the disease course does not justify its cost and potential harms. This decision underscores the ongoing challenges in developing effective treatments for this devastating neurodegenerative condition.
Limited Efficacy and Significant Risks
According to the Zorginstituut, the effect of lecanemab is so minimal that patients are unlikely to experience a noticeable improvement in their daily functioning. Despite receiving treatment, individuals with early Alzheimer’s continue to experience cognitive decline. Crucially, the drug carries a risk of serious adverse events, including brain hemorrhages and brain swelling. These side effects, even as sometimes asymptomatic, can lead to severe complications such as paralysis, speech impairment, and severe confusion, and in rare cases, can be fatal. The Zorginstituut’s report details these findings.
The assessment focused on patients with early-stage Alzheimer’s, a subset who might theoretically benefit most from interventions aimed at slowing disease progression. However, even within this group, the Zorginstituut found the benefits of lecanemab to be insufficient to warrant public funding. The institute advises the Minister of Health, Welfare and Sport (VWS) to exclude lecanemab from the basic health insurance package.
How Lecanemab Works and the Ongoing Debate
Alzheimer’s disease is characterized by the accumulation of amyloid plaques and tau tangles in the brain, disrupting neuronal function and leading to cognitive decline. Lecanemab is an antibody designed to target and remove amyloid plaques. While the drug has demonstrated the ability to reduce these plaques, the clinical impact of this reduction remains a subject of debate. As reported by NRC, the Zorginstituut determined that clearing these protein deposits had a negligible effect on the disease’s progression.
The decision follows earlier assessments by the Dutch Health Council, which similarly expressed reservations about new Alzheimer’s medications, noting that many patients are diagnosed too late for these treatments to be effective. The European Medicines Agency (EMA) approved lecanemab in 2024, and donanemab received a positive assessment in 2025, but the Health Council cautioned that these drugs are unsuitable for a large proportion of patients due to the stage of their illness and the intensive, costly, and risky nature of the treatments. Medisch Contact provides further details on this context.
Impact and Future Outlook
The Zorginstituut’s recommendation is likely to disappoint patients and families affected by Alzheimer’s disease who had hoped for a new therapeutic avenue. The decision highlights the complex challenges of evaluating and funding innovative treatments for neurodegenerative diseases, where clinical benefits may be modest and risks substantial. NOS News reports that despite using lecanemab, patients still experience deterioration.
The Minister of VWS will now consider the Zorginstituut’s advice. The final decision on whether to include lecanemab in the basic health insurance package is expected in the coming months. Further research and development efforts will continue to focus on identifying more effective and safer treatments for Alzheimer’s disease, a condition that affects millions worldwide.
Disclaimer: This article provides informational content about health and medicine and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider for any questions you may have regarding a medical condition.
What are your thoughts on the challenges of funding innovative Alzheimer’s treatments? Share your perspective in the comments below.
