A new drug for treating Alzheimer’s has only a marginal impact on people with the early stages of the memory loss disease and should not be included in the basic health insurance package, according to the Dutch health institute Zorginstituut Nederland.

The institute recommends which drugs should qualify for inclusion in the health insurance system and its proposals are generally adopted by the government which is responsible for determining basic insurance coverage.

The drug Iecanemab only has a marginal effect in people with early-stage Alzheimer’s and patients notice too little difference in their daily lives to justify coverage, the institute said. Patients continue to deteriorate and face the risk of serious side effects, including brain bleeds and swelling that can in rare cases be fatal.

Lecanemab, marketed as Leqembi, was approved by the European Commission in April and the manufacturer’s Dutch arm subsequently applied for it to be covered by health insurance.

The drug targets protein build-ups in the brain that are associated with Alzheimer’s and helps the body clear them. However, neurologist and dementia professor Edo Richard from Radboud University told news website Nu.nl that said similar treatments have shown removing deposits does not necessarily translate into better cognitive function or a clear slowdown in decline.

“Treatment with lecanemab does not lead to noticeable changes in daily life,” he said. The therapy also asks a lot from patients, he said, requiring an infusion every two weeks as well as at least one nuclear scan or lumbar puncture and five MRI scans.

Around 80,000 people in the Netherlands have early-stage Alzheimer’s yet only a small proportion would qualify for the drug. Patients must not be in an advanced stage of the disease and must be in generally good health.

In addition, the treatment is intended only for people without a specific gene who face a higher risk of side effects. Fewer than 15% of patients with early-stage Alzheimer’s are expected to meet the criteria.

Zorginstituut chairman Mark Janssen said he understood that the decision would be disappointing.

“Alzheimer’s is a devastating disease, and lecanemab is the first medicine that seeks to influence the underlying disease process,” he said. “It is disappointing for patients and their families that this is not the breakthrough they hoped for. We hope that further research will deliver better treatments in the coming years.”