U-turn on drugs offers hope in dementia cases

Hundreds of thousands of people denied access to Alzheimer's drugs could now get them after a U-turn by the health watchdog, it was announced today.

The National Institute for Health and Clinical Excellence (Nice) caused huge controversy in 2006 and 2007 when it ruled the key medicines would only be available to people in moderate stages of the disease.

Campaigners argued it was “cruel and unethical” to force patients with early-stage Alzheimer’s to wait until they became worse before they could get the drugs.

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Today, Nice published new draft guidance saying the medicines should now be made available to people with mild disease – potentially benefiting thousands of sufferers.

The guidance, which is subject to appeal, says Aricept (donepezil), Reminyl (galantamine) and Exelon (rivastigmine) will be made available to people with mild as well as moderate disease.

It also recommends the use of Ebixa (memantine) for severe disease and for some patients with moderate disease. Previously, it was only on offer to patients as part of a clinical trial.

The drugs, which cost around 2.80 a day, do not offer a cure for Alzheimer’s disease.

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But they have been shown to improve everyday functioning, including improving the ability to pay attention and plan.

For some people, they can stabilise everyday function for at least six months, and have been shown to increase alertness, improve mood and restore people’s confidence.

Evidence is increasing that the drugs can also alleviate anxiety, depression and apathy.

Nice’s chief executive, Sir Andrew Dillon, said: “Since we published our guidance in September 2007 clinical trials have continued to show the positive effects of these drugs and, in the case of memantine, have reduced the uncertainty about its clinical effectiveness.

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“In addition, we now have more information about the costs of living with and treating this very distressing disease, as it progresses through its mild, moderate and severe stages.

“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.”

The interim chief executive of the Alzheimer’s Society, Ruth Sutherland, said: “This decision stands to benefit hundreds of thousands of people.

“The drugs aren’t a miracle cure but they can make important differences to people’s lives.

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“For the price of a cup of coffee they can mean the difference between recognising your loved ones and playing with your grandchildren.

“It is critical that this draft decision becomes a reality and that all people with Alzheimer’s are given the opportunity to benefit from these treatments.

“It will be important to ensure any new guidance is monitored closely to end postcode prescribing and ensure these drugs are available across the country.”

Rebecca Wood, chief executive of the Alzheimer’s Research Trust, said: “This welcome proposal gives all people living with Alzheimer’s the best possible chance of benefiting from the treatments we have available.

“These drugs hold the promise of relief from the symptoms of Alzheimer’s for thousands of people.”

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