Leqembi may be prescribed at major hospitals in Korea

Lands in over 30 institutions, including the ‘Big 5’ hospitals

Delay in cognitive decline proven through Clarity AD trial

The new Alzheimer's drug ‘Leqembi’ has secured prescription access at tertiary general hospitals in Korea.

According to industry sources, Eisai Korea's Leqembi (lecanemab) has now been approved by the Drug Committees (DC) of major hospitals nationwide, including the Big 5 medical institutions—Samsung Medical Center, Seoul National University Hospital, Seoul St. Mary's Hospital, Asan Medical Center, and Severance Hospital in Sinchon—as well as Gachon University Gil Medical Center, Korea University Guro Hospital, Konkuk University Medical Center, Pusan National University Hospital, Busan Paik Hospital, Seoul National University Bundang Hospital, Chonnam National University Hospital, Jeonbuk National University Hospital, and Hallym University Sacred Heart Hospital.

Since its domestic launch at the end of 2024, prescriptions have expanded rapidly.

Leqembi selectively binds to beta-amyloid (β-amyloid, βA), known to be a causative substance of Alzheimer’s disease, and has been proven to slow disease progression and delay cognitive decline.

However, Leqembi is not yet covered by insurance. The annual drug price is approximately KRW 35 million in the U.S. and about KRW 27 million in Japan. It is expected to take considerable time before being listed for reimbursement due to prolonged negotiations between the pharmaceutical company and the government.

Leqembi demonstrated statistically significant results in both primary and secondary endpoints in the Clarity AD clinical trial. In particular, the Leqembi treatment group delayed clinical cognitive decline by 27% compared to the placebo group over an 18-month period.

However, while the market for amyloid-targeted therapies like Leqembi generally acknowledges their effectiveness in delaying the onset of dementia, the characteristic side effects associated with their use are cited as a major obstacle.

Amyloid-Related Imaging Abnormalities (ARIA), which is often cited as a problem, refers to abnormal signals such as brain edema or microhemorrhages detected via MRI following drug administration.

Depending on the nature of the side effects, ARIA is classified into “ARIA-E,” characterized by cerebral vascular edema and extravascular extravasation, and “ARIA-H,” characterized by microhemorrhages and hemosiderosis findings.

Meanwhile, last year, a special committee composed of 11 members from the Korean Dementia Association established and released domestic guidelines for Leqembi use.

The guidelines include specific details on ▲ patient selection criteria ▲ necessary tests and preparations prior to administration ▲ administration methods ▲ monitoring, and management of drug-related adverse reactions ▲ counseling for patients and caregivers.