Treatments
Every FDA-approved medicine for Alzheimer’s disease and its symptoms, with prices and dates, organised by where in the illness a person actually is — because the answer in the prodrome is different from the answer after a diagnosis, and most of the confusion comes from mixing the two.
Nothing on this page recommends starting, changing or stopping any treatment. There is no ranking here, no “best”, and no formulary. Those decisions belong to the prescriber, who knows the person, the other conditions and the other medicines.
What this page is for is walking into the appointment already knowing what exists. The prices are list or cash prices, gathered on 18 September 2026 and not what anyone with coverage pays; they are here because the gap between them is large enough to be worth a question. Every price and date is sourced at the foot of the page.
This platform does not decide who is eligible for anything. Eligibility for the amyloid drugs requires confirmed amyloid pathology, which needs a scan, a spinal tap or a blood test that a clinician orders. A questionnaire cannot establish it.
Track one
Where this platform actually operates
There is no approved disease-modifying drug for this stage. Not one. Anti-amyloid therapy requires confirmed amyloid pathology and mild cognitive impairment or mild dementia; the blood tests are cleared only for people already showing signs or symptoms. That is the honest state of it, and anyone who tells a family otherwise is selling something.
What the evidence supports at this stage is not a prescription pad. It is three things, and the first is the best-value intervention in this entire document:
The unglamorous answer is that in the prodrome the highest-value medicine is usually one the person is already eligible for, costs almost nothing, and nobody has checked.
Track two
Where the new generation of medicines applies
Two anti-amyloid antibodies are fully approved. They slow decline; neither stops nor reverses it. Both require confirmed amyloid pathology, APOE ε4 genotyping before starting, and MRI monitoring for ARIA — brain swelling and small bleeds, which can be serious and, rarely, fatal. Risk is higher in people homozygous for APOE ε4.
What changed this year: on 13 July 2026 the FDA approved a subcutaneous autoinjector starting dose for Leqembi, so treatment can begin at home rather than with fortnightly infusions. That is a real access change — and it does not change eligibility, the ARIA monitoring, or the price.
Track three
Memory and thinking, and agitation
These do not alter the disease. They may temporarily improve or stabilise memory and thinking in some people, or help manage agitation. This is where the price differences are largest and least examined, which is the subject of the value section below.
Annual figures are list or cash prices without insurance, as of 18 September 2026. Per-fill figures are discount-card cash prices and vary by pharmacy.
| Medicine | Company | Status | For whom | Cost |
|---|---|---|---|---|
| Leqembi lecanemab-irmb |
Eisai / Biogen | Full approval July 2023. Subcutaneous at-home starter dose approved 13 July 2026. | Confirmed amyloid, MCI or mild dementia. APOE ε4 testing advised first. | $26,500/yr Medicare covers with registry |
| Kisunla donanemab-azbt |
Eli Lilly | Full approval 2 July 2024. | Same stage. Clears plaque faster; some people can stop once plaques clear, so total cost varies. | ~$32,000/yr duration varies |
| Aduhelm aducanumab-avwa |
Biogen | Withdrawn. Accelerated approval June 2021; discontinued early 2024. | — | was $56,000, then $28,200 |
Why Aduhelm is still on this page. It is the cautionary case: approved on a surrogate endpoint over its own advisory committee’s objection, priced at $56,000, barely adopted, and withdrawn. Anyone assessing the two drugs above should know that the first one of these did not survive contact with practice.
| Medicine | Company | Status | Notes | Cost |
|---|---|---|---|---|
| Auvelity dextromethorphan / bupropion |
Axsome | Indication added 30 April 2026 — the first non-antipsychotic approved for this. | Boxed warning: suicidal thoughts and behaviours in adolescents and young adults. Also seizure risk, raised blood pressure, and possible activation of mania. Blood pressure and bipolar history should be checked first. | ~$600–900/mo ~$7,200+/yr |
| Rexulti brexpiprazole |
Otsuka / Lundbeck | Approved May 2023 — the first medicine of any kind indicated for it. | An antipsychotic. Carries the class boxed warning of increased mortality in older adults with dementia-related psychosis. Weight and akathisia monitoring. | ~$1,000/mo ~$12,000/yr |
| Medicine | Type | Status | Notes | Cash price |
|---|---|---|---|---|
| memantine | generic | Long established | NMDA antagonist. Moderate to severe stages. | from ~$18/fill |
| galantamine | generic | Long established | Cholinesterase inhibitor. GI side effects are the usual reason people stop. | from ~$28/fill |
| Razadyne ER | brand | Long established | Extended-release galantamine. | from ~$338/fill |
| Aricept | brand (donepezil generic) | Long established | Donepezil is available generically for a fraction of the brand price. | from ~$523/fill |
| Exelon | brand (rivastigmine generic) | Long established | Also used in Parkinson’s-related dementia. Patch available. | from ~$671/fill |
| Namzaric | brand combination | No generic | Memantine plus donepezil in one capsule. Both components are generic separately. | from ~$611/fill |
| Zunveyl benzgalantamine | brand | Approved late 2024, launched 2025 | A prodrug of galantamine with delayed-release enteric coating, designed to bypass the stomach and reduce the GI side effects that make people stop taking galantamine. | ~$3,000–5,000/yr |
You asked whether there are better-value, equally effective options. On this evidence, in three places, yes — and in one place, no.
The independent verdict on the price of the new drugs
ICER put lecanemab’s health-benefit price benchmark at $8,900 to $21,500 a year. It launched at $26,500.
Its appraisal panel voted 15–0 that the drug at its announced price represents “low” long-term value for money, and 12–3 that the evidence was not adequate to demonstrate a net health benefit compared with supportive care alone. ICER described the clinical effect as a mild slowing of decline, with significant uncertainty about whether benefits exceed risks outside a trial.
What that does and does not mean. It does not mean the drug does not work, and it is not a reason for anyone to refuse a treatment their clinician recommends. It means the price is above what an independent body judged the benefit to be worth, and that the size of the benefit is genuinely contested. A family paying attention deserves to know both.
Institute for Clinical and Economic Review, final evidence report on lecanemabGeneric memantine from about $18 a fill and galantamine from about $28, against Razadyne ER at $338, Aricept at $523, Exelon at $671 and Namzaric at $611. Donepezil and rivastigmine both have generics; the brand rows above are the brand prices, not the only way to get those molecules.
This is the clearest value finding on the page. Where a person is taking a brand cholinesterase inhibitor or memantine and paying brand prices, the active ingredient is frequently available generically. That is a conversation with a prescriber or pharmacist, and it is often a short one.
Benzgalantamine is a prodrug of galantamine. The active molecule is the same one available generically from about $28 a fill; what is different is the delivery, engineered to bypass the stomach and reduce the GI side effects that are the commonest reason people abandon galantamine altogether.
So the honest question is not “is it better” but “is the tolerability worth the difference for this person” — which depends entirely on whether that person has already failed generic galantamine because of side effects. For someone who has, a medicine they can actually keep taking is worth a great deal. For someone who has not tried the generic, the value case has not been tested.
Blood pressure below 130 systolic has a randomised trial behind it showing 15% less all-cause dementia sustained over seven years, and generic antihypertensives cost a few dollars a month. Nothing else on this page has that ratio of evidence to cost.
Alongside it: treating depression, treating pain, reviewing an anticholinergic-heavy medicine list, checking thyroid and B12, addressing sleep. All generic, all cheap, and several of them can make a picture that looked like decline look different.
Auvelity is a fixed-dose combination of two molecules that are each generic separately, and it would be easy to conclude that the two generics are a cheaper equivalent. They are not. The combination exists because one component changes how the other is metabolised, the resulting exposure is the point, and it is the combination that was studied in the trials the FDA approved — a five-week randomised trial on the Cohen-Mansfield Agitation Inventory and a randomised withdrawal study.
Assembling it from parts is a prescribing decision with different pharmacokinetics and no trial behind it. That is a decision for a prescriber and not an inference from a price list, and this page will not suggest otherwise.
Clinical trials are themselves an option, and the one most often forgotten. Volunteers are needed at every stage, including people who are cognitively normal. The Alzheimers.gov Clinical Trials Finder lists them by location.
It does not choose treatments and it cannot establish eligibility for any of them. No questionnaire can confirm amyloid. What a quarterly record does is answer the question that decides which track a person is on — has anything changed, and in which direction — with dates on it, and hand that to the clinician who does decide.
It matters most in track one, because that is where almost nothing is written down today and where the highest-value interventions are the ones most easily missed. And it matters at the boundary into track two: the blood tests that can now be ordered in primary care are cleared for people already showing signs or symptoms, so something has to establish that signs are present. A dated run of sittings does that better than a recollection in a fifteen-minute visit.
This section is ours. Everything above it is sourced below.
If you are worried about someone right now, that is a reason to call their clinician rather than to wait for a quarterly review. In crisis, call or text 988 (Suicide & Crisis Lifeline). The Alzheimer’s Association Helpline is 800.272.3900, 24 hours a day.