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NICE releases draft guidelines on Alzheimer's treatments

Date published: 23/01/2006

The National Institute for Health Clinical Excellence (NICE) has released its initial recommendations on drugs to treat Alzheimer's disease. The body's appraisal committee is recommending that donepezil, galantamine and rivastigmine should be considered as treatments of people with the disease.

The drug memantine is not being recommended, as there was insufficient evidence on its clinical benefit, although final guidance after consultation will be given in July. Proposals also include new restrictions on the prescription to people in the early and late stages of dementia. NICE chief executive Andrew Dillon said: "We are acutely aware of our responsibility to help people with Alzheimer's disease secure access to effective treatment. We needed to make the right decision, based on all the relevant evidence.
"By going the extra mile and asking the drug companies to delve deeper into their clinical trial data, we have been able to identify the right way to use these medicines. People with Alzheimer's will now receive these drugs when they can help them most. They and those who care for them will be able to feel more confident about gaining benefit from them and the NHS will know that its using its funds to best effect." The decision has been welcomed by Shire Pharmaceuticals, which makes galantamine under the name Reminyl.

John Freeman, Shire managing director, said: "Shire is encouraged that the new Nice appraisal consultation document for AD [Alzheimer's disease] acknowledges that the acetylcholinesterase inhibitor class of drugs are both clinically effective and cost-effective for the treatment of moderate AD and that they will remain available on the NHS.

"This is good news for new patients at the moderate stage of their disease and for their carers. However NICE also states that new patients diagnosed with mild AD will not be eligible for these drugs on the NHS until their condition deteriorates to moderate AD, which we do not agree with."

Neil Hunt, of the Action on Alzheimer's Drugs alliance, welcomed the fact no blanket ban was introduced and the effectiveness of the drugs was recognised. He said: "However, the new draft guidance that NICE has produced still raises serious ethical and practical concerns about the availability of drug treatments for people with Alzheimer's disease. We will be highlighting these concerns during this consultation process. Unfortunately, the agonising wait for people with dementia and their carers goes on."

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