Alzheimer’s: Nice stands firm on drug restrictions for mild cases

The National Institute for Health and Clinical Excellence has refused to reverse guidance urging the NHS to deny drug treatments to people with mild cases of Alzheimer’s, to the ire of campaigners.

The Alzheimer’s Society said the decision would mean thousands of people with Alzheimer’s would continue to be denied access to the only drug treatments for the disease, after Nice produced revised guidance today.

This upheld the recommendations of original guidance produced in 2006, which recommended that NHS bodies only provide donepezil, galantamine and rivastigmine to patients in the moderate stages of the disease on the basis that they are not cost-effective for milder cases.

Nice agrees review

However, Nice has agreed to review its appraisal of the treatments.

Alzheimer’s Society chief executive Neil Hunt said: “We are extremely disappointed to see that the Nice guidance is essentially unchanged, despite what we feel are fundamental flaws in the economic model they have used to inform their recommendations.”

He said the promised review offered a “glimmer of hope” that this “incomprehensible decision will be changed”.

‘Technical inaccuracies’

Today’s revised guidance follows a consultation launched last year on the economic model used by Nice to reach its conclusion, which highlighted “technical inaccuracies” and led to amendments to the original guidance.

Nice chief executive Andrew Dillon said: “Although these comments resulted in minor changes to the model, our independent advisory committee concluded that these were not enough to make these treatments a cost-effective sue of NHS resources in the mild stages of the disease.”

Nice was ordered last year to release an “executable” version of the model for consultation by the Court of Appeal, following a legal challenge by drugs manufacturer Eisai. Unlike the “read only” version Nice had previously published, the executable version allowed campaigners to put different numbers into the model and make new calculations.

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