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The NHS is not ready for a new era of diagnosing and treating Alzheimer’s disease, nor is the UK “keeping pace with the science”, experts have warned.
The Alzheimer’s landscape is set to be transformed in the coming years thanks to new drugs and blood tests, yet a group of 40 researchers said that without rapid reform, the potential of these “major innovations” will not be realised.
Writing in a series of papers published in The Lancet, the researchers also claim the “game-changing” medications donanemab and lecanemab slow the progression of Alzheimer’s as effectively as treatments do for other conditions such as cancer, rheumatoid arthritis and multiple sclerosis.
Both treatments received a UK licence last year, for use on early-stage Alzheimer’s. However, despite this, neither is available on the NHS because the spending watchdog deemed them not cost-effective.
The researchers’ warning follows news that British patients will trial a new blood test for Alzheimer’s, with results expected within three years. But even if successful, patients could miss out on “big breakthroughs” as a result of the UK falling behind, a leading charity said – meaning any new treatments may not be available on the NHS for many years.
The lead author of the papers, Professor Giovanni Frisoni, of the University of Geneva, said there is a need for societal change to ensure current and future Alzheimer’s patients benefit fully from scientific advances.
“Blood tests, biological drugs for Alzheimer’s disease, and prevention interventions are propelling care into entirely new and exciting territory,” he said.
“However, the old needs of patients will not disappear. On the contrary, more general practitioners and dementia specialists will need to master the less glamorous but steady advances made in the past few decades in the care and treatment of behavioural disorders, the use of sophisticated diagnostic imaging and laboratory tools, and psychosocial care.
“A concerted societal effort in this direction will enable our current and future patients to benefit fully from the potential of scientific and technological advances.”
The Alzheimer’s drugs pipeline
An annual review of the Alzheimer’s drug pipeline earlier this year showed that there were 182 clinical trials assessing 138 drugs in 2025 – a 9 per cent increase in the number being investigated compared to 2024.
The pipeline now consists of 48 Phase III (31 drugs), 86 Phase II (75 drugs), and 48 Phase I (45 drugs). Experts said it is notable that the number of Phase I trials has increased by 85 per cent since 2024 (from 26 to 48), demonstrating the industry’s rising emphasis on innovation.
Disease-targeting therapeutics (DTTs) dominate the pipeline, accounting for 74 per cent. Some 14 per cent of therapies seek to improve cognitive function while another 11 per cent treat neuropsychiatric symptoms such as agitation, psychosis, and apathy.
The researchers also highlight that Alzheimer’s drugs donanemab and lecanemab slowed disease progression to a level comparable to the efficacy of medicines for cancer, rheumatoid arthritis and multiple sclerosis.
Both treatments have been licensed by the Medicines and Healthcare products Regulatory Agency (MHRA) for use in the UK, but will not be made available on the NHS after the National Institute for Health and Care Excellence (Nice) deemed their benefits “too small” to justify their cost.
Professor Frisoni said the understanding of Alzheimer’s was going to “change radically in the near future”.
He added: “As it happens in all medical revolutions, it’s not something that takes place overnight, it will take place over years, but the path has clearly been taken, and there’s no way back.
Blood tests for the disease “have the possibility to upscale diagnosis tremendously”, he said.
“Of course, other conditions are different; multiple sclerosis is different from Alzheimer’s disease. But there are some dimensions that we can use as an anchor to compare these drugs.
“And when you do this exercise, you realise that these drugs for Alzheimer’s are not more toxic, are not less effective, are not more expensive. What is really different is the potential size of the beneficiaries. This is the real difference. The discussion shifts from a clinical discussion to a political discussion. Does society want to invest?”
Dr Richard Oakley, associate director of research and innovation at Alzheimer’s Society, said the series of papers “mark the beginning of a new era in Alzheimer’s disease diagnosis and treatment”.
However, he added: “The painful truth is that the NHS is simply not ready and isn’t keeping pace with the science. We now run the very real risk that people living with dementia will miss out on the opportunity to benefit from these big breakthroughs.
“It’s vital that the UK Government keeps its eye on the ball so people with dementia aren’t left behind. We want to see better access to early diagnosis so people don’t miss out on the narrow window of eligibility to benefit from treatments which can slow Alzheimer’s disease. Preparing for future treatments will take a society of researchers, clinicians and decision-makers.”
David Thomas, head of policy and public affairs at Alzheimer’s Research UK, said that “scientific momentum alone is not enough” to improve the situation for people with dementia.
“Turning research breakthroughs into change for people affected by dementia is a challenge that governments and health service leaders must address,” he added.
An NHS spokesperson said: “The NHS is currently giving patients access to every approved, evidence-based and cost-effective approach for dementia diagnosis and treatment, and we have been working to ensure local services are ready to roll out any new treatments for early-stage Alzheimer’s which are approved by Nice in the future.”
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