News Release

1 March 2005 (updated 2 March 2005)

NICE guidelines - dementia drugs may no longer be recommended

NICE (National Institute Clinical Excellence), part of the UK's National Health Service, has recommended today that all Alzheimer's drugs should no longer be used in the treatment of mild to moderate Alzheimer's disease. This is a reversal of guidance issued in 2001.

This is a preliminary recommendation from NICE, there will be further consultation and review, so these recommendations may change. Final guidance will be issued in July. NICE is accepting public comments on this recommendation via their website until March 22 (see below). Until final guidance is issued in July, the current NICE recommendations still apply. If the final guidance upholds these preliminary recommendations, the medications will still be available but it will for Health Authorities in England and Wales to decide whether or not to reimburse their cost.

The recommendations issued today state that donepezil (Aricept), galantamine (Reminyl), and rivastigmine (Exelon) should not be used as a treatment of mild to moderate Alzheimer's disease. The fourth drug, memantime (Ebixa) considered for the first time by NICE, is not recommended for the treatment of moderate to severe Alzheimer's disease. The report states that there is evidence that all four drugs show some beneficial effects in patients, but recommends they are not prescribed for cost benefit reasons.

General opinion in the UK is that this is a drastic recommendation and does not reflect the fact that some people have a good response to these medications or are slowed in their overall progression. Those who do respond to these drugs, should have a chance to benefit, rather than to not prescribe them at all. The health economic modelling outlined in the report is complex. There is not sufficient quality of life data in dementia and more research is needed to determine quality of life in dementia and make assessments about the cost effectiveness of these drugs.

The Alzheimer's Society, Alzheimer's Scotland and the Alzheimer's Research Trust all based in the UK have reacted strongly and have condemned this decision. Please see press releases below.

For the full recommendations and an opportunity to comment please visit the document on the NICE website [http://www.nice.org.uk/page.aspx?o=245912 - no longer available].

Reaction from the UK

Reaction internationally

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