Dementia drugs “divert funds from quality care”

LONDON (Reuters) – Memory clinics and drugs to slow the
progress of symptoms of Alzheimer’s disease are diverting
resources in Britain’s state-funded health services from high
quality integrated care, doctors said on Friday.

The treatments known as cholinesterase inhibitors have been
recommended by the country’s cost-effectiveness watchdog, the
National Institute for Health and Clinical Excellence (NICE),
for patients with mild-to-moderate Alzheimer’s disease since
2001.

But psychiatrist Anthony Pelosi of the Hairmyres Hospital
in East Kilbride, Scotland and his colleagues said memory
clinics that were set up to prescribe and monitor the medicines
have distorted clinical priorities.

“These clinics are diverting resources from high quality
integrated care,” Pelosi said in a report in The British
Medical Journal.

He added that the drugs, which cost about 1,000 pounds
($1,907) per patient per year, have turned out to be of
marginal benefit from statistical, clinical and public health
perspectives.

Although memory clinics recruited multidisciplinary staff,
Pelosi and his colleagues said there is a shortage of mental
health professionals in Britain and the clinics also do not
offer care in the community for their patients as their illness
progresses.

Patient groups and care organizations hailed the 2001
decision by NICE which stressed that further research would be
needed and that the recommendation would be reviewed in several
years.

In March 2005, NICE recommended that doctors stop giving
the drugs to new patients because they were not cost effective.
The Royal College of Psychiatrists and the Association of the
British Pharmaceutical Industry condemned the decision, which
NICE said was provisional and subject to consultations.

An estimated 12 million people worldwide suffer from
Alzheimer’s which is the leading cause of dementia in the
elderly.

Pfizer Inc and Eisai Co’s Aricept; Novartis AG’s Exelon;
and Reminyl, made by Johnson & Johnson and distributed in
Britain by Shire Pharmaceuticals (SHP.L> Group Plc are leading
cholinesterase inhibitors.

“Whatever the final outcome of NICE’s deliberations, the
human and financial resources that have become tied up in
clinics organised around prescription of cholinesterase
inhibitors must be diverted to old age psychiatry teams and
their social care counterparts,” Pelosi added.