Opinion
Medicine for all - or none
Article no. 18 · April 10, 2026 · Updated September 20, 2026 ·
Two new drugs can slow down Alzheimer's disease. The effect is limited and the price is high. Therefore, authorities and regions are now hesitating. But Swedish healthcare cannot choose a middle ground: either the treatment is offered to all patients who can benefit from it – or it is not used at all.
Lecanemab and Donanemab are the first treatments that actually affect the disease by slowing its progression – but only to a limited extent. They do not cure the disease.
And they are very expensive.
Difficult situation
The Swedish Medical Products Agency has given the green light for the safety of both medicines but has limited their use to hospital specialists. The National Board of Health and Welfare is working feverishly to update national guidelines to define which patients should be prioritized.
For Leqembi, the Dental and Pharmaceutical Benefits Agency (TLV) states in its analysis that there is a "very high uncertainty" in the underlying data. It is difficult to calculate exactly how great the long-term benefit is and whether it is worth the high price. TLV has submitted its analysis to the regions' decision-making body (NT Council) and suggests that they await until the price and financing issues are resolved.
For Donanemab (Kisunla) – the health economic assessment is ongoing at TLV.
Expensive drugs, moderate effect
For both agents, the effect is moderate and the treatment is risky. Negotiations are ongoing with pharmaceutical companies regarding the price.
Meanwhile, proposals for compromise are heard. Introduce the treatments – but only for a very limited group of patients. Perhaps at a few university hospitals. Perhaps under the designation of follow-up or research.