The UK government will move ahead with plans to restrict the use of drugs to treat Alzheimer’s disease to patients with moderate symptoms, according to the National Institute of Health and Clinical Excellence (NICE).
NICE, which is charged with determining the cost-effectiveness of drugs prescribed under the National Health Service in England and Wales, said that it would not relax its stance on the issue, despite an appeal by drugmakers, patients groups and other interested parties.
In a statement, NICE chief executive Andrew Dillon said: “we realise that today’s announcement will be disappointing to people with Alzheimer’s and those who treat and care for them. But we have to be honest and say that based on all the evidence, including data presented by the drug companies themselves, our experts have concluded that these drugs do not make enough of a difference for us to recommend their use for treating all stages of Alzheimer’s disease.”
The ruling, due to come into effect in November, affects the cholinesterase inhibitors on the UK market, namely Eisai/Pfizer’s Aricept (donepezil), Shire’s Reminyl (galantamine) and Novartis’ Exelon (rivastigmine).
The Alzheimer’s Society, which represents patients in the UK, said it was ‘outraged’ by the decision not to allow the drugs to be prescribed for patients in the early or later stages of the disease.
“What sort of society have we become when the health of hundreds of thousands are sold to save just £2.50 a day?” said Neil Hunt, the society’s chief executive.
“This blatant cost cutting will rob people of priceless time early in the disease and later clinicians will have no choice but to use dangerous sedatives that increase the risk of heart disease and stroke. This is victimisation of the most vulnerable in society.”
Another approved treatment, Lundbeck’s glutamate antagonist Ebixa (memantine), is approved for moderately-severe Alzheimer’s but should only be used in clinical trials because its value is unproven, according to the NICE.
In a statement, Lundbeck said it was disappointed with that verdict, but pointed out that the NICE guidance “does not apply to Ebixa for patients with the moderate stage of the disease, where evidence in clinical trials shows Ebixa delays clinical worsening.”
“Therefore, Ebixa is an NHS treatment option that can be initiated as early as moderate Alzheimer’s disease,” it added.
The agency said it would publish a clinical guideline next month to sit alongside the recommendations on drug treatment and spell out the care and support that should be given to people in all stages of Alzheimer’s disease.
