The FDA approved the first Alzheimer’s drug that may really work. A Penn physician explains why you probably can’t get it, yet

The FDA on Friday authorized the use of the Alzheimer’s drug lecanemab, the first drug clearly shown to slow the progress of the debilitating brain disease.

But the treatment will not be widely available at first, as insurers are not expected to cover it until the agency reviews additional evidence about the drug’s effectiveness.

That review may come later this year. Yet even then, policy experts warn that the health-care system will have trouble accommodating — and paying for — treatment of the millions who will be eligible.

Studies suggest the drug is modestly beneficial for people in the early stages of Alzheimer’s, allowing them to retain more of their memory and thinking skills than people who don’t take the drug. As with any drug, there is a risk of side effects — in this case, swelling and bleeding in the brain.

Here are the key points to keep in mind, with a big assist from neurologist David Wolk, codirector of the Penn Memory Center.

What is lecanemab?

Lecanemab consists of antibodies that bind to abnormal proteins that accumulate in the brains of people with Alzheimer’s disease. That’s what the -ab stands for at the end of the drug’s name.

Once the antibodies latch onto these sticky proteins, called beta amyloid, the immune system removes them from the brain.

The drug is administered via hourlong infusions every two weeks for up to 18 months. Made by Tokyo-based Eisai, it will be sold under the brand name Leqembi.

Who can get the new Alzheimer’s drug?

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