Eli Lilly has made Kisunla (donanemab) available in Ireland via private prescription from 12 August 2026, following EU marketing authorisation in September 2025, with an application submitted to the HSE for public reimbursement. Treatment is available through a Controlled Access Programme at approved centres, subject to eligibility confirmation.

Eli Lilly (NYSE: LLY) is an Indianapolis-headquartered global pharmaceutical company and the world's largest by market capitalisation, with FY2025 revenues of $45.9 billion (€42 billion). Kisunla received EU-wide marketing authorisation in September 2025, based on phase 3 TRAILBLAZER-ALZ 2 data.

The treatment is indicated for adults with mild cognitive impairment or mild dementia due to Alzheimer's disease who are ApoE ε4 heterozygotes or non-carriers with confirmed amyloid pathology, administered intravenously every four weeks. The US list price is approximately $32,000 (€29,300) per year; Irish private prescription pricing has not been disclosed. Approximately 20,000 patients in Ireland are potentially eligible under the approved indication.

For Ireland's private healthcare sector, the Kisunla launch creates an immediate clinical opportunity and a significant operational challenge simultaneously. Private hospitals and clinics with neurology or memory assessment services are best positioned to establish approved centre status under the Controlled Access Programme, a designation that requires confirmed eligibility pathways, specialist oversight, safety monitoring infrastructure and intravenous infusion capacity.

The hospitals that move earliest to establish that infrastructure will capture the first-mover advantage in a treatment category where approximately 20,000 eligible patients have no public alternative.

The structural driver is the gap between EU regulatory approval and public reimbursement. Irish health economic modelling published in April 2026 found a cost-effectiveness ratio of €371,299 per QALY, 8.3 times above Ireland's €45,000 NCPE threshold. That gap makes HSE reimbursement structurally improbable in any near-term timeframe, meaning private prescription is the only access route available.

The Controlled Access Programme structure ensures clinical governance is maintained outside public reimbursement, while building the real-world Irish evidence dataset that Lilly will need for any future reimbursement negotiation with the NCPE.

For private healthcare providers, this is the commercial model that disease-modifying Alzheimer's therapy will follow in Ireland for the foreseeable future — a high-cost, specialist-administered treatment accessible only through private pathways, where the quality of the assessment and monitoring infrastructure determines which centres attract and retain patients.

Source: irishpharmacynews.ie / ema.europa.eu / statnews.com / ssrn.com / pharmaceutical-technology.com