First ever Alzheimer's drug has arrived in India for almost one lakh per dose

Dubai: For decades, treating Alzheimer's has largely meant managing symptoms. A new drug launched in India this month is trying to change that, though the reality is more nuanced than the headlines suggest.

US pharmaceutical giant Eli Lilly, one of the world's largest drugmakers, has launched donanemab in India under the brand name Lormalzi. It is being described as a significant milestone for Alzheimer's treatment in the country, and in many ways it is. But neurologists are careful to frame exactly what the therapy can and cannot do.

What is it and how does it work

Lormalzi is a monoclonal antibody given as a monthly intravenous infusion. It works by targeting and clearing amyloid beta plaques, the abnormal protein deposits in the brain associated with Alzheimer's disease progression. The idea is that by removing these plaques early, the drug can slow the pace at which the disease damages cognition and independence.

Dr Anas Abdul Majeed, consultant neurologist at Medcare Al Safa, explains it simply. The drug is intended for patients in the early stages of Alzheimer's, specifically those with mild cognitive impairment or mild dementia, with confirmed amyloid plaques in the brain. It does not cure Alzheimer's and it cannot reverse damage that has already occurred. What it may do, in the right patients, is buy time.

Clinical studies have shown the therapy may help slow the progression of cognitive decline in eligible patients diagnosed in the early stages of the disease. Specifically, the landmark TRAILBLAZER-ALZ 2 trial, published in the Journal of the American Medical Association, showed donanemab slowed clinical decline by 35.1 per cent over 76 weeks in patients with early symptomatic Alzheimer's who had both amyloid and tau pathology.

Is it actually available elsewhere

This is not an experimental drug. As Dr Abdul Majeed confirms, donanemab is marketed globally as Kisunla and has received regulatory approval in the United States, the United Kingdom, Japan, China, Australia, the European Union, the UAE, Qatar, Kuwait, Bahrain and several other countries. India's launch makes it one of the more recent additions to that list, and notably the first time a disease-modifying Alzheimer's therapy has been available in the Indian market.

Lilly has described itself as a global pioneer in Alzheimer's research for over 35 years, and the Indian launch reflects its stated commitment to advancing evidence-based intervention for patients in the country.

Who can actually take it

This is where it gets more complicated. The therapy is not a general memory treatment and it is not for everyone with an Alzheimer's diagnosis. Patients need to be in the earliest symptomatic stages and must have confirmed amyloid pathology, which typically requires either an amyloid PET scan or cerebrospinal fluid analysis. In India, amyloid PET imaging is currently not widely available, which is one of the practical challenges surrounding the drug's rollout.

Patients with advanced Alzheimer's, prior brain bleeds, uncontrolled hypertension or those on strong blood thinners may not be suitable candidates. The drug carries a risk of amyloid-related imaging abnormalities, known as ARIA, which can involve brain swelling or small areas of bleeding. Regular MRI monitoring throughout treatment is considered essential.

What is available in the UAE

For residents in the UAE, Alzheimer's treatment options span both traditional and newer approaches. Dr Abdul Majeed outlines that standard management currently includes symptomatic medications such as donepezil, rivastigmine, galantamine and memantine, alongside lifestyle support, cognitive stimulation, caregiver education and management of sleep, mood and behavioural symptoms.

On the more advanced end, the UAE has also approved newer disease-modifying therapies. Both donanemab and lecanemab are reported as available for selected patients with early Alzheimer's disease in the country.

However, as Dr Abdul Majeed emphasises, accessing these treatments requires careful patient evaluation, confirmation of amyloid pathology, ongoing MRI monitoring and thorough risk assessment. They are not walk-in prescriptions, and the process of determining eligibility is itself a significant undertaking.

The cost question

The drug's availability does not automatically mean accessibility. A single dose costs approximately Rs 91,688, roughly the equivalent of Dhs4,000, and the treatment course runs for around 18 months. Eli Lilly has said it will run an access programme to help bring costs down for some patients, but the financial barrier remains significant for most families in India.

Why it still matters

Despite the caveats, neurologists say the arrival of this class of therapy is genuinely meaningful. Dementia currently affects approximately 8.8 million people in India, with Alzheimer's accounting for the majority of cases, and that number is projected to nearly double by 2036. The arrival of a disease-modifying option, however limited in its current reach, is expected to push clinicians toward earlier diagnosis and more biomarker-based assessment, which could benefit patients even before the cost barriers are resolved.

As Dr Abdul Majeed puts it, the drug is real, it is approved, and it works in the right patients. The challenge now is making sure those patients can actually be identified, evaluated and reached in time for it to make a difference.