News Release

23 January 2006

NICE guidelines: dementia drugs to be denied to those in the mild and severe stages of the disease

On 23 January NICE (National Institute of Clinical Excellence), part of the UK's National Health Service(NHS), released a further consultation document regarding treatment for people diagnosed with Alzheimer's disease in England, Wales and Northern Ireland. Although the document reverses some of its earlier negative recommendations to completely withdraw anti-dementia drugs from the National Health Service, it now proposes to limit treatment to the moderate stages of the disease and to exclude people with Alzheimer's disease in the mild and severe stages. These proposals are based on cost-benefit reasons.

The recommendations issued yesterday state that:

1. Donepezil (Aricept), galantamine (Reminyl), and rivastigmine (Exelon) should be used as a treatment for moderate stages of Alzheimer's disease only - that is those with a MMSE score of between 10 and 20 points.

2. Memantine (Ebixa), used to treat more severe stages of the disease, be withdrawn from the NHS. It would no longer be available on prescription and the only way people would receive Ebixa would be as part of clinical research trials.

Despite expectations that NICE would reach a final decision, this recommendation remains at the preliminary stage, there will be further consultation and review, so these recommendations may change. In the meantime, people already being prescribed drugs will continue to receive them. NICE's appraisal committee will meet again on 27 April 2006 once it has considered feedback from the consultation process but a final decision is not expected until late spring.

The Alzheimer's Society and other organisations have reacted strongly to the series of NICE recommendations. By forming the Action on Alzheimer's Drugs Alliance and actively campaigning they have succeeded in reversing the initial recommendation to remove all dementia drugs from the NHS. However, action is still needed to prevent discriminatory measures being taken against people with the mild and severe forms of Alzheimer's disease, and their campaign is continuing. We congratulate them on their achievement so far and wish them further success.

ADI sincerely hopes that these proposals do not set a precedent for other countries conducting similar appraisals. Worldwide, numbers of people with dementia are rapidly escalating. Governments need to recognise the scale of the problem and invest in care and treatment, rather than withdrawing it. Effective treatments for all stages of dementia are needed to improve the quality of life for those 24 million people with dementia worldwide and their carers.

For the full recommendations and an opportunity to comment please visit the document on the NICE website.

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About NICE

NICE, The National Institute for Clinical Excellence (NICE) is part of the NHS. It is the independent organisation responsible for providing national guidance on treatments and care for people using the NHS in England and Wales. NICE guidance is intended for healthcare professionals, patients and their carers to help them make decisions about treatment and healthcare.

NICE guidance is developed using the expertise of the NHS and wider healthcare community including NHS staff, healthcare professionals, patients and carers, industry and the academic community.

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