{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T13:02:51Z","timestamp":1784984571600,"version":"3.55.0"},"reference-count":30,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP23dk0207048"],"award-info":[{"award-number":["JP23dk0207048"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP24dk0207054"],"award-info":[{"award-number":["JP24dk0207054"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP24dk0207068"],"award-info":[{"award-number":["JP24dk0207068"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP25dk0207075"],"award-info":[{"award-number":["JP25dk0207075"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"name":"MHLW Special Research Program","award":["JPMH23CA2008"],"award-info":[{"award-number":["JPMH23CA2008"]}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP24K10653"],"award-info":[{"award-number":["JP24K10653"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP25K19014"],"award-info":[{"award-number":["JP25K19014"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Alzheimer's Disease Reports"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The approval of lecanemab has created new operational demands for Alzheimer's disease care. Japan's nationwide rollout under universal health insurance offers an opportunity to identify real-world bottlenecks in treatment delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify facility-level and infrastructure-level factors associated with wait time to initial lecanemab infusion and treated patient volume among dementia specialists in Japan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a secondary analysis of an anonymous online survey of 296 dementia specialists certified to prescribe lecanemab in Japan approximately one year after approval. We examined associations between physician\/facility characteristics, diagnostic and infusion resources, perceived implementation barriers, and two delivery metrics: wait time from first consultation to first infusion and number of treated patients per respondent. Bayesian accelerated failure-time and zero-truncated Poisson mixed-effects models were used.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Approximately 80% of respondents reported average wait times of 3 months or less, whereas the median treated caseload was modest at 5 patients per physician. Perceived mismatch between treatment capacity and demand was associated with longer wait time (time ratio 1.323, 95% credible interval 1.045\u20131.682). Cerebrospinal fluid (CSF)-dominant amyloid-testing strategies tended to be associated with smaller caseloads, while in-house CSF testing and\n                      <jats:italic toggle=\"yes\">APOE<\/jats:italic>\n                      testing were associated with larger caseloads. High-volume centers reported constrained outpatient infusion space. Lack of reimbursement for infusion-related tasks and\n                      <jats:italic toggle=\"yes\">APOE<\/jats:italic>\n                      testing were perceived as major system-level barriers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Japan's rollout may be constrained by some bottlenecks in diagnostics, infusion infrastructure, and uncompensated tasks. Appropriate policy interventions might help secure equitable access to the treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/25424823261470054","type":"journal-article","created":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T12:44:21Z","timestamp":1784983461000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Identifying facility-level and infrastructure-level bottlenecks in Japan's lecanemab rollout through an online survey of dementia specialists"],"prefix":"10.1177","volume":"10","author":[{"given":"Saki","family":"Nakashima","sequence":"first","affiliation":[{"name":"The University of Tokyo"},{"name":"The University of Tokyo Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4351-9526","authenticated-orcid":false,"given":"Kenichiro","family":"Sato","sequence":"additional","affiliation":[{"name":"The University of Tokyo Hospital"},{"name":"The University of Tokyo"},{"name":"The University of Tokyo Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiki","family":"Niimi","sequence":"additional","affiliation":[{"name":"The University of Tokyo Hospital"},{"name":"The University of Tokyo Hospital"},{"name":"The University of Tokyo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryoko","family":"Ihara","sequence":"additional","affiliation":[{"name":"Tokyo Metropolitan Institute for Geriatrics and Gerontology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7308-5314","authenticated-orcid":false,"given":"Atsushi","family":"Iwata","sequence":"additional","affiliation":[{"name":"Tokyo Metropolitan Institute for Geriatrics and Gerontology"},{"name":"Tokyo Metropolitan Institute for Geriatrics and Gerontology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiyotaka","family":"Nemoto","sequence":"additional","affiliation":[{"name":"University of Tsukuba"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuaki","family":"Arai","sequence":"additional","affiliation":[{"name":"Institute of Medicine, University of Tsukuba"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinji","family":"Higashi","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Ibaraki Medical Center, Tokyo Medical University, Inashiki-gun, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6307-6916","authenticated-orcid":false,"given":"Ataru","family":"Igarashi","sequence":"additional","affiliation":[{"name":"Department of Public Health, Yokohama City University School of Medicine, Yokohama-shi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2178-0769","authenticated-orcid":false,"given":"Kensaku","family":"Kasuga","sequence":"additional","affiliation":[{"name":"Niigata University"},{"name":"Department of Diagnostic Innovation Science, National Center for Geriatrics and Gerontology, Obu-shi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruhiko","family":"Akiyama","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, Yokohama Brain and Spine Center, Yokohama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuichi","family":"Awata","sequence":"additional","affiliation":[{"name":"Tokyo Metropolitan Institute for Geriatrics and Gerontology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manabu","family":"Ikeda","sequence":"additional","affiliation":[{"name":"The University of Osaka Graduate School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsushi","family":"Toda","sequence":"additional","affiliation":[{"name":"The University of Tokyo"},{"name":"National Institute of Neuroscience, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Iwatsubo","sequence":"additional","affiliation":[{"name":"The University of Tokyo Hospital"},{"name":"The University of Tokyo"},{"name":"The University of Tokyo Hospital"},{"name":"National Institute of Neuroscience, National Center of Neurology and Psychiatry, Kodaira, Tokyo, 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LEQEMBI Optimal Use Guideline [Article in Japanese] https:\/\/www.mhlw.go.jp\/content\/12404000\/001178607.pdf (2023 accessed 13 December 2023)."},{"key":"e_1_3_3_11_2","doi-asserted-by":"crossref","unstructured":"Kinoshita S and Kishimoto T. Addressing the barriers to promoting lecanemab use: Preventing Intergenerational Conflicts to Build a Sustainable Healthcare System. BMJ 2025; 389: r796.","DOI":"10.1136\/bmj.r796"},{"key":"e_1_3_3_12_2","unstructured":"Mix Online. Eisai FY2025 Q3 Financial Results Briefing. 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