Malta Braces for Alzheimer’s Breakthrough: Who Will Pay for New EU-Approved Leqembi?

EU Green-Lights Alzheimer’s Drug Leqembi: What It Means for Malta’s 7,000 Families Living With Dementia
By Christiana Micallef, Hot Malta Health Correspondent

Valletta – While Brussels bureaucrats shook hands on the 19 July decision, the real applause this week echoed down the narrow limestone alleys of Żabbar, where 72-year-old Marlene Camilleri has just learnt that her husband’s early-onset Alzheimer’s may soon be treated with the first drug that actually slows the disease instead of only masking symptoms.
“After three years of watching Joe fade away, we finally have a timeline that isn’t a countdown,” she told Hot Malta, clutching the carers’ hotline number that NGO Alzheimer’s Malta has been circulating since Monday’s European Commission approval of lecanemab, sold as Leqembi.

The landmark authorisation—conditional but reimbursable—makes the IV infusion available to patients with mild cognitive impairment or mild dementia who test positive for beta-amyloid on PET scans or spinal taps. Price tag abroad: €20,000–€25,000 per year. Who pays in Malta? That is the next battle.

Local context: a micro-state with macro stakes
Malta’s population may be 520,000, yet we punch above our weight in dementia prevalence. National statistics show 7,000 diagnosed cases, projected to double by 2050 as the island’s over-65 cohort swells faster than any EU average. With one in four Maltese providing informal care—often daughters squeezed between childcare and career—the drug’s arrival is cultural as much as clinical.

“Families here don’t ‘place’ relatives in homes easily,” explains Dr. Charles Scerri, founder of the Malta Dementia Society. “Three-generation households are still the norm in villages like Qormi and Żejtun. A therapy that buys even 18 months of independent functioning keeps the breadwinner at work and the elder at the window watching the village feast.”

Medical community split
At Mater Dei Hospital’s neurology ward, consultants are cautiously optimistic. Leqembi’s phase-III data shows a 27 % reduction in cognitive decline over 18 months, but also brain-swelling risks that require bi-monthly MRI monitoring. Mater Dei currently shares one 3T MRI scanner between all neuro patients; adding 200–300 new infusion cases could stretch radiology queues already criticised in EU Health System reviews.

“We need a national protocol, not a postcode lottery,” says Dr. Josanne Aquilina, head of geriatrics. “Will scans be free? Will the drug be bundled in the government formulary or fall under the rare-disease ‘high-cost pool’? These questions determine whether a Gozitan farmer’s wife gets the same shot as a Sliema lawyer.”

Political reaction: faster than a pastizz cools
Health Minister Jo Etienne Abela reacted within hours, promising a “rapid-health-technology assessment” and pledging to “explore EU solidarity mechanisms for joint procurement.” Opposition health spokesperson Stephen Spiteri urged caution, recalling Malta’s 2021 scramble to fund spinal-muscular-atrophy drug Zolgensma, which ballooned the national medicines bill by €14 million.

Meanwhile, the Malta Medicines Authority has already received the manufacturer’s dossier; local reimbursement could be decided by October, officials tell Hot Malta.

Community impact: from parish halls to pharmacy queues
In Birkirkara, the St. Helen’s Dementia Day Centre is preparing information sessions in Maltese and English. “Relatives ask: ‘Will Nanna get better?’ We have to explain this is slowing, not curing,” says coordinator Maria Pace. Still, the psychological boost is tangible. Volunteers report renewed interest in memory-screening pop-ups planned for the Santa Marija feast week—usually prime time for fundraising doughnut sales, not serious neurology.

Pharmacies are bracing too. The Malta Chamber of Pharmacists warns that Leqembi’s cold-chain storage (2–8 °C) and intravenous administration will likely restrict delivery to hospital out-patients, at least initially. “We don’t want a repeat of the COVID-vaccine scramble where village clinics bought fridges that still sit empty,” president Alison Zammit Maempel remarks.

Bottom line for families
Until Malta’s reimbursement verdict, Marlene Camilleri is pinning hopes on a compassionate-use scheme. “Joe was the one who carried the statue of Our Lady of Graces every August. If a few more months let him walk beside it again, that’s grace enough.”

Across the island, thousands share her fragile optimism. The EU has opened the door; now Malta must decide who walks through—and who foots the bill.