UK cost watchdog backs limited Alzheimer drug use

By Ben Hirschler, European Pharmaceuticals Correspondent

LONDON (Reuters) – Britain’s cost-effectiveness watchdog
NICE said on Monday that Alzheimer’s drugs which can help, but
not cure, some patients should be used in a minority of people
with the degenerative brain disease.

The decision is a partial climbdown by the National
Institute for Health and Clinical Excellence (NICE), which last
year suggested that so-called anti-cholinesterase drugs were
not worth the money for any patients.

The new guidance, which is subject to further consultation
but is likely to become final by July 2006, means that three
drugs will in future be prescribed on the state health service
– but only for patients with Alzheimer’s disease of moderate
severity.

Such cases, accounting for approximately 40 percent of the
total, include people with a mini mental state examination
(MMSE) score between 10 and 20 points.

Newly diagnosed Alzheimer’s patients with mild disease will
not get access to the medicines.

The NICE deliberations have been monitored by governments
around the world, who increasingly have to weigh up the
benefits of modern medicines against their price.

The drugs cost around 1,000 pounds ($1,750) per patient a
year.

Andrew Dillon, the chief executive of NICE, said the plan
for restricted use had been drawn up after analysis of
additional clinical information provided by manufacturers.

“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,” he said.

“People with Alzheimer’s will now receive these drugs when
they can help them most.”

Pfizer Inc and Eisai Co Ltd’s Aricept is the market leader
among anti-cholinesterase treatments.

Rival products include Reminyl, from Johnson & Johnson and
Shire Pharmaceuticals Group Plc, and Novartis AG’s Exelon, both
of which are used like Aricept to treat mild to moderate
Alzheimer’s.

A fourth drug, Ebixa, is made by Lundbeck and is given to
patients with more serious disease. But Dillon said there was
insufficient evidence of Ebixa’s clinical benefit in this group
and it should therefore not be used, except in the context of
clinical studies.

Pfizer and Eisai welcomed the NICE move but said some
patients would still lose out.

Alzheimer’s is a growing problem around the globe, with a
team of international researchers recently predicting that the
number of people suffering from dementia was set to double
every 20 years and could reach more than 81 million worldwide
by 2040.