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Public acceptance and expectations for Lecanemab: Insights from a Smallest Worthwhile Difference study.
Aran Tajika1, Kenji Omae1,2, Ethan Sahker3
1Department of Health Promotion and Behavioral Sciences, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan.
Psychiatry and Clinical Neurosciences
|May 20, 2026
Summary
The public
Area of Science:
- Neuroscience
- Pharmacoeconomics
- Public Health
Background:
- Alzheimer's disease (AD) poses a significant public health challenge.
- Lecanemab is a novel disease-modifying therapy for AD.
- Understanding patient and public perception of treatment value is crucial for drug adoption.
Purpose of the Study:
- To determine the smallest worthwhile difference (SWD) for lecanemab in Japan.
- To assess public expectations of lecanemab's efficacy using a benefit-harm trade-off.
- To explore psychological factors influencing treatment value perception.
Main Methods:
- An online survey of 658 Japanese participants was conducted.
- SWD was calculated as the minimum acceptable improvement in cognitive function maintenance.
- Preferences were evaluated considering lecanemab's risks, side effects, and costs.
Main Results:
- The median SWD was a 15% increase in cognitive function maintenance, exceeding lecanemab's actual 8% efficacy.
- Nearly half of respondents found the current efficacy worthwhile, with 17% reporting zero SWD due to AD fear.
- No significant difference in SWD was observed between scenarios involving family members versus others.
Conclusions:
- Public expectations for lecanemab's efficacy in Japan surpass its demonstrated benefit.
- Psychological factors like fear and hope significantly shape the perceived value of AD treatments.
- Clinicians should manage patient expectations, acknowledging diverse preferences and emotional influences.
