NICE updates Alzheimer's drugs guidance Print
Three drugs that NICE previously said should be withheld until the moderate stages of Alzheimer’s disease will, under new draft guidance, now also be recommended as an option at the mild stage of the disease. NICE’s decision has been widely welcomed by people with Alzheimer’s and by charities that campaigned for earlier use of the drugs.
The charge that NICE took the wrong decision in September 2007 to withhold the drugs – donepezil (Aricept), galantamine (Reminyl) and rivastigmine (Exelon) – until people had reached the moderate or severe stage of Alzheimer’s was rejected by the Chief Executive of NICE, Sir Andrew Dillon. He 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.
“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The new draft guidance also recommends that memantine (Ebixa) may be prescribed for people with severe Alzheimer’s disease, and for people with moderate disease who are intolerant of, or have a contraindication to, acetylcholinesterase inhibitors.
Ruth Sutherland from the Alzheimer’s Society welcomed the new draft guidance. She 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. For the price of a cup of coffee they can mean the difference between recognising your loved ones and playing with your grandchildren.”
She stressed the importance of fair implementation of the guidance: “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.”