India launches first Alzheimer’s therapy at ₹91,688 per dose

Alzheimer’s patients in India now have access to the country’s first disease-modifying treatment, with pharmaceutical major Eli Lilly launching donanemab under the brand name Lormalzi. The monthly 350 mg infusion is designed to slow disease progression by targeting and clearing amyloid-beta plaques in the brain, a hallmark of Alzheimer’s disease.

The monoclonal antibody therapy is meant for patients in the early stages of the disease, specifically those with mild cognitive impairment or mild dementia. Clinical studies have shown it can slow cognitive decline by nearly 30%, offering a new treatment avenue in a disease area where breakthroughs have remained limited.

However, the therapy comes with a steep cost. A single vial is priced at ₹91,688, making the full 18-month treatment prohibitively expensive for most Indian patients. While the company has announced a patient access programme to lower out-of-pocket costs, affordability remains a major concern.

“This launch reflects our long-term commitment to advancing innovation and supporting evidence-based intervention for people living with Alzheimer’s,” Winselow Tucker, president and general manager of Eli Lilly India, said in a statement, adding that the company would work with healthcare stakeholders to improve patient access.

The drug’s arrival is significant given India’s rising dementia burden. Around 8.8 million people in the country currently live with dementia, with Alzheimer’s accounting for the majority of cases. That number is projected to nearly double to 16.9 million by 2036, underscoring the urgent need for effective therapies.

Still, experts caution that the treatment is not a cure. While donanemab helps remove amyloid build-up, it cannot reverse existing brain damage, making early diagnosis critical. That remains a challenge in India, where Alzheimer’s is often detected late.

The treatment also requires extensive patient screening and monitoring. Eligible patients must undergo genetic testing for the APOE4 gene, which is linked to a higher risk of side effects, alongside regular imaging to detect potentially serious complications such as brain swelling or bleeding.

In its phase 3 trial involving 1,736 patients, donanemab slowed cognitive decline by 35.1% over 76 weeks. But the study also found that 24% of participants experienced brain swelling and 19.7% had brain bleeds, with three treatment-related deaths reported.

Globally, donanemab is among only a handful of approved Alzheimer’s therapies, alongside Leqembi and Aducanumab, all aimed at reducing amyloid plaque build-up. While these drugs have renewed hope in Alzheimer’s care, their cost, risks and modest benefits continue to fuel debate among clinicians and health systems worldwide.