MARA rated lecanemab (Leqembi) B++ (Marginal) before G-BA published Beschluss 7692 on 19 February 2026. The B++ grade correctly identified the marginal and uncertain zone — G-BA’s outcome of kein Zusatznutzen for both patient subgroups represents the more negative outcome within that range. The primary G-BA rationale — 18 months of observation insufficient to establish long-term benefit — maps directly to the two domains MARA rated as Weak: Uncertainty (“significant uncertainties regarding long-term efficacy”) and Care Pathway Integration (MRI monitoring and amyloid testing requirements flagged as implementation constraints). MARA’s Clinical Effectiveness and HRQoL domains were rated as Strong, reflecting the CLARITY-AD phase 3 signal; G-BA’s finding of no additional benefit was driven by evidence maturity rather than absence of clinical signal — a distinction the B++ grade captured in direction but not in degree.