NICE updates Alzheimer's drugs guidance

“Hundreds of thousands more patients in the early stages of Alzheimer's disease could get drug treatments following a U-turn by the health watchdog,” BBC News reported.

Widespread news coverage has been given to new draft guidance from NICE for the treatment of Alzheimer’s disease. If the draft decision is upheld, the guidance would update previous recommendations for the NHS provision of the drugs donepezil, galantamine and rivastigmine for people in the early stages of the disease. 

In 2007, NICE recommended that only people with ‘moderate’ symptoms of the disease should get the drugs. The decision, which caused some controversy, was based on research available at the time. The new draft guidance recommends that people with mild symptoms should also get them, and also recommends a fourth drug, Ebixa, for people with severe Alzheimer’s.

This draft guidance does not yet change the current situation regarding prescription of drug treatments. The guidance must still go through consultation, and the final decision on the drug’s use will be made later this year.

The Chief Executive of NICE, Sir Andrew Dillon, said that the decision had been made based on growing numbers of clinical trials showing the positive effects of the drugs, and better information on the costs of living with and treating the disease throughout its progression.

The latest available data from 2005 suggests that for England and Wales 380,000 people have Alzheimer’s disease. Around 50 to 64% are estimated to have mild to moderately severe disease, and about 50% have moderately severe to severe disease. As there is currently no cure for Alzheimer’s disease, these drugs are used to treat the symptoms. They do not slow the progression of the disease, but can delay admission to residential care (nursing homes, etc.).

The Alzheimer’s Society website has published comprehensive information on the issue, the drugs themselves, and access to the drugs.