Alzheimer's drugs could be withdrawn

The National Institute of Clinical Excellence (NICE) has recommended the withdrawal of three drugs frequently used to help treat the symptoms of Alzheimer's disease.

Following an assessment of the drugs, draft guidance was issued by NICE and while this is subject to a consultation and may subsequently be redrafted, the guidance proposes that the drugs are not suitable for use in treating Alzheimer's disease.

According to the NICE Appraisal Committee's preliminary recommendations donepezil, rivastigmine and galantamine are not recommended for use in the treatment of mild to moderate Alzheimer’s disease. The guidance indicates that people currently receiving these drugs may continue to take them until it is "considered appropriate to stop".

The drugs were previously recommended by NICE in 2001 as providing some relief from symptoms. The guidance from the clinical watchdog does not imply that the drugs are ineffectual, simply that the NHS bill in relation to patient benefits may be too high.

Commenting on the NICE guidance, Neil Hunt, Chief Executive of the Alzheimer’s Society, said: "We are shocked by NICE’s initial recommendations, which, if finally approved, will deny thousands of people with dementia the only drug treatment available to them. These drugs are not a cure. They don’t work for everybody. But they can make a real difference to quality of life and their importance to many carers and people with dementia cannot be overestimated.

"NICE believes that these drug treatments are not good value for money. We think they are. These drugs cost about £2.50 a day. NICE seems to have concluded that people with dementia are a group that it is not worth spending money on. We all need to let NICE know why they have got it wrong."

The Alzheimer’s Society has requested that its members respond to the NICE consultation document.

Following the publication of the draft guidance, a review on the recommendation will take place in March 2005. Final guidance is expected to be published in July 2005.

The Association of the British Pharmaceuticals Industry said that withdrawal of approval to use the drugs could lead to a reduction in research directed towards improved drugs for Alzheimer's disease.

Alzheimer’s disease, usually found in the elderly, is difficult to diagnose, as the symptoms are mild at first but develop progressively over a period of years, until sufferers eventually become unable to cope for themselves.

(SP)