Extending Alzheimer's Drugs Availability

Researchers from the Peninsula Technology Assessment Group (PenTAG), part of the Peninsula College of Medicine and Dentistry, carried out a review of research evidence, that played a very important role in the decision taken by the National Institute for Health and Clinical Excellence (NICE), to extend the availability of Donepezil, Galantamine, Memantine and Rivastigmine for Alzheimer's disease.

“Alzheimer's disease and dementia are a growing problem for the UK,” said Professor Chris Hyde from PenTAG.

“The Alzheimer's Society estimates that there are 750,000 people with dementia in the UK today, and that this figure will grow to over one million by 2025.

“The costs associated with the disease are huge, with over 60,000 deaths attributed to dementia and a national financial cost to the country of £20 billion.

“Our work for NICE allows a rigorous and independent re-assessment of the balance of research evidence for additional patient benefits against the extra costs to the NHS of providing different treatments.”

NICE carried out a prior assessment of these drugs, in 2004, and it approved the use of Donepezil, Galantamine and Rivastigmine for people with moderate Alzheimer's disease, but restricted the use of Memantine to clinical trials.

The institute requested a review of new evidence, as part of its ongoing review of its previous decisions, which was conducted by PenTAG, an institution independent from NICE.

The results showed that not much had changed and that all the drugs managed, to some extent, to delay symptom progression in Alzheimer's.

As for the estimates used in the previous economic model, PenTAG noted the uncertainty surrounding them and concluded that this influenced its results.

So the researchers developed a new economic model, differently calibrated, which maintained some uncertainty but showed that the drugs are cost-effective.

As a consequence, NICE's appraisal committee extended the availability of Donepezil, Galantamine and Rivastigmine to people with mild Alzheimer's disease, and Memantine to those with severe forms of the illness.