Real-world lecanemab adoption in Japan 1 year after launch: Insights from 311 specialists on infrastructure and reimbursement barriers

Lecanemab was approved for early Alzheimer's disease in Japan, with ≈ 6000 patients treated in the first year post approval. This study explores real-world practices, challenges, and potential solutions.

We conducted an anonymized online survey of clinical specialists authorized to prescribe lecanemab, obtaining responses from 311 specialists who collectively treated 3259 patients with lecanemab.

A majority of respondents (79%) reported wait times of ≤ 3 months from first consultation to initial infusion. One fourth reported tight outpatient space and staffing and significantly lower capacity of treatment than anticipated. Safety concerns were limited, with amyloid imaging-related abnormality-related interruptions in 3.5%. More than half highly supported additional reimbursement for infusion-related services and insurance coverage for apolipoprotein E (APOE) testing.

Early access to lecanemab appears feasible, yet infrastructure and financial hurdles remain. Dedicated reimbursement and insurance coverage for APOE testing may be essential for ensuring safer, more accessible, and sustainable use of this therapy in Japan.

Results from an online survey of 311 Japanese specialists prescribing lecanemab in its first year are reported. Majority of wait times from first consultation to initial infusion were 1 to 3 months. Tight affordability of infusion space and staffing was reported by one quarter. Establishing additional medical fee for infusion management was highly expected. Reimbursement of apolipoprotein E test in Japanese health insurance system was also demanded.