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NHS creating post-code lottery for patients with dementia, says charity

Posted: 10 June 2004 | Subscribe Online


People with Alzheimer's still face barriers to accessing anti-dementia drugs - despite their endorsement by the National Institute for Clinical Excellence (Nice), it is claimed.

The Alzheimer's Society says some NHS bodies are either ignoring the Nice guidance or limiting the number of patients given the medication.

In evidence to a Nice review, the charity's report says: "Requiring all patients being considered for drug treatment to pass through a designated clinic has allowed trusts to limit and control access to new treatments.
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"This amounts to post-code prescribing by proxy. In some areas patients have been told that drugs cannot be prescribed until funds for a memory clinic have been found."

Nice first advised NHS bodies to prescribe Aricept, Reminyl and Exelon three years ago, while a fourth drug Ebixa is available only on private prescription.

A new survey of 4,000 people with Alzheimer's and their carers finds that two-thirds had experience of at least one of the four drugs, and that nearly three-quarters of this group said the treatments worked.

Medication is effective in 80 per cent of cases, there is no evidence of harm and side effects are minor, the charity argues.

A spokesperson said: "One branch felt unable to distribute our questionnaire because local consultants were not prescribing medication. It is distressing for people to know that there are drugs that may help but they cannot access them."
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The report calls for GPs and other primary care professionals to be allowed to diagnose Alzheimer's and prescribe medication to avoid bottlenecks and delays.

Ageism is also factor in the refusal of drug treatment, the report claims. A carer for an 80-year-old in Sutton, south London, was told that anyone over 70 was "too old" for treatment.

People with dementia in residential and nursing care homes are the most likely to be refused medication, the report adds.

A further 5 per cent of respondents had been refused medication because they lived alone and there was no-one to supervise administration of the drug.


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