Lecanemab uptake constrained by infusion infrastructure, not demand
Real-world rollout of lecanemab is gated by infusion-chair capacity and MRI monitoring schedules - not by patient interest or prescriber willingness.
Lecanemab (Leqembi) requires biweekly intravenous infusion plus serial MRI to monitor for amyloid-related imaging abnormalities (ARIA). Health systems that have publicly described their rollout consistently identify the same bottlenecks:
- Infusion-chair capacity - particularly outside academic medical centers.
- MRI scheduling for the protocol-defined surveillance points.
- Specialist time for ARIA review and management decisions.
None of these are unique to lecanemab. They are the same constraints that shaped early biologics rollouts in oncology and rheumatology. What is different is the patient population - Alzheimer's care has historically lived inside primary care and outpatient neurology, neither of which are organized around chronic infusion delivery.
The implications worth tracking are operational: where care actually delivers, how patients travel for it, and whether subcutaneous formulations meaningfully decompress the bottleneck once they arrive. The subcutaneous formulations are now under regulatory review - for the plain-language picture of what changes (and what does not), see our explainer on what subcutaneous anti-amyloid antibody therapy is and why it matters for access.
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Key sources
- FDA prescribing information - Leqembi (lecanemab)
- Published health-system anti-amyloid rollout reports
- Eisai/Biogen post-launch disclosures