UK cost agency to end curbs on Alzheimer’s drugs

Britain’s healthcare cost agency plans to end controversial restrictions on Alzheimer’s drugs in a policy U-turn that could give hundreds of thousands of patients access to previously denied medicines.

The National Institute for Health and Clinical Excellence (NICE) said on Thursday it was recommending that three anti-cholinesterase drugs should be offered on the state health service for mild as well as moderate disease.

NICE caused a storm in 2006 with its original decision that these medicines should be restricted to patients with moderate Alzheimer’s and not offered to those in the early stages of the debilitating brain condition.

Its new draft guidance now states that Aricept, from Japan’s Eisai and Pfizer, as well as Shire’s Reminyl and Novartis’s Exelon, should be a treatment option on the National Health Service for people with both mild and moderate forms of Alzheimer’s.

NICE also recommended a fourth drug, Lundbeck’s Ebixa, for severe disease and for some patients with moderate disease. Previously, Ebixa’s use was limited to clinical trials.

Doctors and patient groups applauded the change of heart by NICE, whose decisions are closely monitored by healthcare authorities in other countries.

“If this guidance is issued, doctors will no longer have to watch people deteriorate without being able to treat them,” said Clive Ballard, director of research at the Alzheimer’s Society.

“Being able to prescribe in the best interest of their patient will also be a strong incentive for GPs to diagnose Alzheimer’s disease earlier and for people to go to their doctor if they are worried about their memory.”

The draft decision is subject to appeal but is likely to be adopted.

HELP BUT NOT CURE

Gordon Wilcock, professor of clinical geratology (applied gerontology) at the University of Oxford, said the change of heart was “marvelous news” and brought Britain into line with many other Western countries.

Anti-cholinesterase drugs, which cost around 2.80 pounds ($4.50) per person a day, can help but not cure some Alzheimer’s patients.

NICE’s initial assessment was that their benefits were too small to justify the cost. But Chief Executive Andrew Dillon said more positive data from clinical trials in the past three years had strengthened the case for using the drugs.

The agency also looked at more information about the costs of living with and treating Alzheimer’s in reaching its decision, he added.

“Our increased confidence in the benefits and costs associated with the use of the three drugs for treating mild and moderate stages of the disease has enabled us to make a positive recommendation for their use in mild disease,” he said.

Some 750,000 people in Britain suffer from some form of dementia and more than half have Alzheimer’s, according to the Alzheimer’s Society.

Since 1999, NICE has led the world in measuring the cost-effectiveness of new treatments but its decisions have often proved controversial and it has restricted access to some medicines that are widely used in other markets.

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By Ben Hirschler

LONDON (Reuters)