Alzheimer’s innovation is advancing quickly, but many treatments remain costly, high-risk, and outside NHS provision. For insurers and case handlers, understanding these developments is key to anticipating claims involving dementia.
Dementia remains one of the UK’s most pressing public health challenges. It is a leading cause of death, with Alzheimer’s Research UK reporting that one in two people will be affected by dementia in their lifetime (1). Among those over 65, one in 14 are currently living with the condition.
Given its prevalence, dementia frequently arises in casualty claims—either as a pre-existing condition or one that develops following an accident. For case handlers, this raises complex questions around causation, prognosis and treatment options. Staying informed about medical developments is therefore essential, particularly as innovation in Alzheimer’s diagnosis and treatment accelerates.
The research landscape: Innovation vs implementation
Alzheimer’s disease accounts for 60–70% of dementia cases (2), making it a primary focus of global research. As of 2025, more than 1,800 clinical trials and 138 novel drugs are in development (3).
Despite years of headlines touting “breakthrough” treatments, the reality in the UK remains sobering. Most new therapies have not been adopted by the NHS (4), and patient care continues to centre on symptom management. Available medications do not offer a cure.
As Professor Robert Howard of UCL recently cautioned in The Times (5), expectations should be tempered: while new drugs may offer hope, they are unlikely to benefit those already living with the disease today.
Amyloid-targeting therapies: Promise and limitations
A major focus of therapeutic development has been amyloid-targeting drugs. These treatments aim to remove amyloid beta plaques, which are strongly associated with Alzheimer’s progression. However, the relationship between plaque burden and symptoms is not straightforward: some individuals with substantial plaque accumulation remain cognitively intact, while others with fewer plaques experience severe decline. Tau protein abnormalities and broader brain health factors are also under scrutiny.
Several monoclonal antibodies have been approved by the U.S. Food and Drug Administration (FDA) in recent years:
- Aducanumab (Aduhelm®) received accelerated approval in 2021 but was subsequently discontinued.
- Lecanemab (Leqembi®) gained approval in 2023.
- Donanemab (Kisunla™) followed in 2024.
These drugs are indicated for patients with early symptomatic Alzheimer’s disease, including mild cognitive impairment. Clinical trials show they can delay progression from mild to moderate Alzheimer’s by 4–6 months. However, they carry substantial risks – most notably brain swelling and bleeding, affecting up to 24% of patients in some Donanemab trials – and are extremely costly.
While approved by the UK’s Medicines and Healthcare products Regulatory Agency (MHRA) in 2024, the National Institute for Health and Care Excellence (NICE) confirmed in June 2025 that neither Donanemab nor Lecanemab would be recommended for NHS use, citing insufficient cost-effectiveness. They remain available privately, but at tens of thousands of pounds per patient, their accessibility is limited.
Recent FDA approvals: Incremental progress
Two FDA approvals in 2025 highlight the continuing pace of innovation:
- May 2025 – Approval of the Lumipulse G pTau217/ß-Amyloid 1-42 plasma test, the first blood test to aid in diagnosing Alzheimer’s. This test detects amyloid plaques in adults over 55 showing symptoms. While not infallible, it represents a significant step towards earlier, less invasive diagnosis.
- August 2025 – Approval of Leqembi® IQKLIK™, a subcutaneous injection form of lecanemab for maintenance dosing. This development enables at-home administration, potentially reducing costs and improving accessibility compared to hospital-based infusions.
Innovation on the horizon
Beyond antibody therapies, other promising avenues are emerging:
- Diagnostic technologies in the UK: Cognitive assessment tools are being refined, with AI-driven approaches such as the CognoSpeak system (University of Sheffield) and the Fastball test (Universities of Bath and Bristol) showing promise in early trials. These tools may combine with blood tests to deliver quicker, more cost-effective diagnoses.
- Tau-targeting therapies: Hydromethylthionine mesylate (HMTM), developed by UK-based TauRX, is under phase 3 trials. This oral therapy has shown indications of slowing cognitive decline with a favourable safety profile. TauRX has applied for MHRA and NICE approval.
- Repurposed drugs: Semaglutide (widely known under the brand names Ozempic and Wegovy) is under investigation for potential cognitive benefits. Results are expected in 2026.
Implications for Casualty claims
For practitioners dealing with casualty claims where dementia may be a factor—whether post-traumatic brain injury (TBI) or pre-existing Alzheimer’s – the pace of medical development is relevant. While there is no cure on the horizon, there is a steady pipeline of diagnostic and therapeutic advances.
In practical terms:
- Requests for investigations or private treatment may arise in litigation. However, given the costs, risks, and limited clinical benefit of current antibody therapies, such requests are likely to be exceptional and carefully scrutinised.
- Pre-accident cognitive history will remain a key area of dispute, requiring expert input.
- Diagnostic innovations may become increasingly relevant as AI-driven cognitive tests and blood-based biomarkers move closer to widespread adoption.
Clinicians remain cautious about offering false hope. For now, the harsh reality is that available drugs are not curative and may only modestly delay disease progression. Nevertheless, the speed of innovation – particularly in diagnostics – offers hope that earlier and more reliable identification of Alzheimer’s will soon be achievable.
Conclusion
The Alzheimer’s treatment landscape is evolving, but progress remains incremental. The UK has taken a more cautious stance than the US, prioritising cost-effectiveness and safety, which has kept novel therapies out of the NHS. For those handling casualty claims, the key takeaway is that while new treatments are emerging, their real-world application remains limited. The focus for the near future will be on earlier, more cost-effective diagnosis rather than transformative therapy. Clyde & Co will continue to monitor developments closely as the landscape shifts.