Furore over who gets Alzheimer's drug in the UK

Nov 20 2006

A furore has erupted in Britain over a decision by the National Institute for Clinical Excellence (NICE), not to recommend the use of an Alzheimer's drug for newly diagnosed patients.

The issue involves four drugs, the most popular of which is being Aricept, (donepezil), which is made by Eisai and Pfizer.

Though the drugs do not represent a cure, they can significantly alleviate a patient's suffering and slow down the progress of the illness's.

NICE have banned the drugs for use by those suffering mild symptoms of Alzheimer's which has put the UK at odds with the rest of the world as Aricept is available in 75 countries across the globe and everywhere else in Europe apart from Albania.

Both Eisai and Pfizer have accused NICE of being less than transparent by repeatedly refusing to reveal details of the computer model which devised the cost-effectiveness of the drug.

They say they are prepared to go to court over the matter and claim the process used by NICE for the guidance was illegal and irrational.

Eisai and Pfizer say NICE should use a more accurate and cost effective model and data.

In the UK anyone receiving an NHS prescription pays just £6.50 ($12) for the one-month-course but NHS patients over 65 receive their prescriptions free.

If a patient has to buy the drug privately it will cost £2.50 ($4.80) per day.

NICE's final decision comes into force on November 22nd and Eisai and Pfizer are asking for the recommendations to be postponed.

Under the guidelines an estimated 50,000 new patients a year with 'mild' disease will be denied access to the drugs and will instead be told to come back when their symptoms are worse.

Never before has the watchdog body had it's recommendation challenged judicially at such a late stage and Alzheimer's support groups throughout England and Wales have welcomed the fight which has the support of 125 members of parliament.

The MPs want the Department of Health to guarantee that doctors will be able to continue to prescribe treatments which are in the best interest of their patients.

The Alzheimer's Society is receiving legal advice as to whether it should launch its own judicial review.

Alzheimer's is a progressive, degenerative brain disease which currently affects more than 4 million Americans and over 750,000 people in the UK.

It afflicts mainly the elderly and the drugs can delay the progression of devastating symptoms such as memory loss, personality changes and erosion of the ability to do everyday things in some patients.

Other drugs which will be restricted to patients with moderate symptoms are Reminyl (galantamine) and Exelon (rivastigmine).

Another drug, Ebixa (memantine), which improves severe behavioural problems is only to be used in clinical studies.