The clinical and cost effectiveness agency for England and Wales has affirmed its decision to allow the three drugs donepezil, galantamine, and rivastigmine to be prescribed only to those Alzheimer's patients with moderate disease.
In affirming its May final guidance on the three drugs, the National Institute for Health and Clinical Excellence on Oct. 11 rejected appeals from 10 organizations and companies. The NICE decision, which will be sent to the National Health Service in November, will limit the use of all three drugs for newly diagnosed Alzheimer's patients.
NICE's final decision was based on cost effectiveness. The drugs cost £890.60 to £1,248.30 per year but do not avert enough costs to justify that expenditure–for example, delaying by less than 2 months the need for full-time care, according to analyses prepared for the NICE committee drafting the guidance.
“Alzheimer's is a cruel and devastating illness, and we realize that today's announcement will be disappointing to people with Alzheimer's and those who treat and care for them,” NICE Chief Executive Andrew Dillon said in a written statement. “But … based on all the evidence, including data presented by the drug companies themselves, our experts have concluded that these drugs do not make enough of a difference for us to recommend their use for treating all stages of Alzheimer's disease.
The Alzheimer's Society criticized the decision. “This blatant cost cutting will rob people of priceless time early in the disease, and later clinicians will have no choice but to use dangerous sedatives that increase the risk of heart disease and stroke,” Neil Hunt, chief executive of the Alzheimer's Society, said in a written statement.