Estimating the eligible population for amyloid-targeting monoclonal antibody therapy in memory clinics: Application to lecanemab in France

Lecanemab was the first amyloid-targeting monoclonal antibody approved by the European Commission for treating patients with mild cognitive impairment (MCI) and mild dementia due to Alzheimer's disease (AD). While this marketing authorization led to heterogeneous situations across European countries, France declined reimbursement, citing limited clinical benefit and concerns about the healthcare system's capacity to implement this new care pathway. This capacity depends directly on the number of eligible patients, yet robust estimates remain limited and highly variable across studies. Our objective was therefore to estimate the population eligible for lecanemab in France. Using transportability methods based on inverse odds of selection weighting, we articulated the nationwide consultation data from the French National Alzheimer Database (BNA) with the deeply phenotyped MEMENTO clinical cohort. Eligibility for lecanemab followed the French appropriate use recommendations: 1) clinical eligibility (age 50-90 years, MCI with common AD phenotype or mild AD dementia, MMSE ≥22), 2) biological eligibility (amyloid confirmation determined sequentially using plasma p-tau217, cerebrospinal fluid biomarkers and amyloid-PET), 3) absence of contraindications (APOEε4 homozygosity, anticoagulant use, MRI risk markers for ARIA). Among patients consulting French memory clinics, 19.5% met clinical eligibility criteria. Of these, 73.0% (95%CI: 67.6-77.9) were amyloid-positive, and 49.7% (95%CI: 44.0-55.5) remained eligible after applying safety criteria. Overall, 9.7% (95%CI: 8.6-10.8) of patients consulting memory clinics were estimated to be eligible for lecanemab, representing approximately 18,200 individuals nationally (annual average, 2022-2024). These results inform healthcare planning for disease-modifying therapy implementation in France and comparable countries.

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Journal
The Journal of Prevention of Alzheimer s Disease
Published
2026-10-14
DOI
https://doi.org/10.1016/j.tjpad.2026.100683
Primary Topic
Alzheimer's disease research and treatments
Type
article
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article

Estimating the eligible population for amyloid-targeting monoclonal antibody therapy in memory clinics: Application to lecanemab in France

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The Journal of Prevention of Alzheimer s Disease
Alzheimer's disease research and treatments
article

Estimating the eligible population for amyloid-targeting monoclonal antibody therapy in memory clinics: Application to lecanemab in France

Marion Andro, Cécile Chazalon, Adrien Chavent, Lisa Le Scouarnec, Cédric Annweiler, Aurélie Buisson, François Cotton, Emmanuelle Comps, Leslie Grasset, Jérémie Belin, Cathérine Belin, Jean‐Philippe Cottier, Pierre Celsis, Théophile Bieth, Marie Bénaiteau, Laure Koch Caillard, Bruno Bouvel, Marine Asfar, Pierre‐Yves Brillet, Olivier Bailon, Pierre Anthony, Emmanuel Cognat, Émilie Beaufils, Valérie Chauviré, Jérôme Bohatier, Yasmina Boudali, Pascaline Cassagnaud, Serge Bracard, Alexandre Augier, Mathilde Choquer, D. Ben Salem, Mariam Annan, Jean‐Marc Bugnicourt, Samia Belkacem, Christine Champion, Edouard Chaussade, Marie‐Odile Barrellon, John Avet, Julien Biberon, Hélène Catalá, Carole Dufouil, Adeline Bannier, Karim Bennys, Nicolas Auguste, Laurent Bailly, Antoine Brangier, Serge Belliard, Stéphanie Bombois, Agnès Camus, Vincent Planche, Claire Boutet, Geneviève Chêne, Fabienne Calvas, Adrien Cohen, Carole Azuar, Catherine Bayle, Clémence Boully, Jasmine Carlier, Vincent Bouteloup, Sophie Chauvelier, Frédéric Blanc, Katia Santos Andrade, Lora Cohen, Samia Cheriet, Catherine Beze, Mathieu Pierre Ceccaldi, Marie Chupin A, Henri de Clermont-Gallerande, Clément Aveneau, Jean Barré, Olivier Beauchet, Christine Astier, Fabrice-Guy Barral, Béatrice Claise, Michèle Allard A, Sandrine Canaple, Anna‐Chloé Balageas, Marie-Hélène Coste, Sophie Auriacombe, Alexandre Berger, Sara Amroun, Anne Chanwakilian, Maria Callejo Plazas, Frédérique Castapatry, Nicolas Bassiere, Antoine Carpentier, Daniela Andruita, Julia Coarelli, Edouard Caltabellotta, Irina Bilubas, Athanase Benetos, Vincent Camus, Ludivine Chamard, Claire Boutoleau Bretonniere, Isabelle Bourdel Marchasson, Alina Berriolo Riedinger, François Bertin Hugault, Michèle Becker Schneider, Yannick Bejot
article en

Abstract

Lecanemab was the first amyloid-targeting monoclonal antibody approved by the European Commission for treating patients with mild cognitive impairment (MCI) and mild dementia due to Alzheimer's disease (AD). While this marketing authorization led to heterogeneous situations across European countries, France declined reimbursement, citing limited clinical benefit and concerns about the healthcare system's capacity to implement this new care pathway. This capacity depends directly on the number of eligible patients, yet robust estimates remain limited and highly variable across studies. Our objective was therefore to estimate the population eligible for lecanemab in France. Using transportability methods based on inverse odds of selection weighting, we articulated the nationwide consultation data from the French National Alzheimer Database (BNA) with the deeply phenotyped MEMENTO clinical cohort. Eligibility for lecanemab followed the French appropriate use recommendations: 1) clinical eligibility (age 50-90 years, MCI with common AD phenotype or mild AD dementia, MMSE ≥22), 2) biological eligibility (amyloid confirmation determined sequentially using plasma p-tau217, cerebrospinal fluid biomarkers and amyloid-PET), 3) absence of contraindications (APOEε4 homozygosity, anticoagulant use, MRI risk markers for ARIA). Among patients consulting French memory clinics, 19.5% met clinical eligibility criteria. Of these, 73.0% (95%CI: 67.6-77.9) were amyloid-positive, and 49.7% (95%CI: 44.0-55.5) remained eligible after applying safety criteria. Overall, 9.7% (95%CI: 8.6-10.8) of patients consulting memory clinics were estimated to be eligible for lecanemab, representing approximately 18,200 individuals nationally (annual average, 2022-2024). These results inform healthcare planning for disease-modifying therapy implementation in France and comparable countries.

The Journal of Prevention of Alzheimer s DiseaseVol. 13(10)
Centre National de la Recherche Scientifique (FR), Inserm (FR), Institut des Maladies Neurodégénératives (FR), Bordeaux Population Health (FR)
Fujirebio US, Fondation Vaincre Alzheimer, Ministère de l'Enseignement supérieur, de la Recherche et de l'Innovation, GE Healthcare, Avid Radiopharmaceuticals
Good health and well-being
Openalex Percentile: Top 14%
Alzheimer's disease research and treatments
DOIOpen Access PDFOpenAlex
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