2009/037 Update On NICE Appraisal Of Drugs For Alzheimer's Disease Following Court Of Appeal Ruling

Main Category: Alzheimer's / Dementia
Article Date: 12 Jun 2009 - 2:00 PDT

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The National Institute for Health and Clinical Excellence (NICE) has announced that, following consultation with stakeholders on the economic model that underpinned NICE's 2006 guidance on the use of drugs to treat Alzheimer's disease, the resulting draft guidance remains unchanged.

In accordance with the Court of Appeal's ruling on the economic model used in the technology appraisal of drugs for the treatment of Alzheimer's disease, NICE released the fully executable version of the model to stakeholders for their comment in November 2008. Having fully reviewed all the resulting comments the Independent Advisory Committee concluded that, although a number of technical inaccuracies were highlighted and amendments were made to the economic model, these were not sufficient to change the original conclusion that these treatments are not cost effective in the mild stages of the disease. NICE guidance on the use of donepezil, galantamine and rivastigmine and memantine for the treatment of Alzheimer's disease therefore remains unchanged and the drugs continue to be recommended only for people with moderate Alzheimer's disease. Consultees now have a chance to appeal against this decision.

Andrew Dillon, NICE Chief Executive said: "We have complied with the Court of Appeal's ruling to release the executable version of the economic model used in this appraisal for consultation and to consider the comments made by consultees. Although these comments resulted in minor changes to the model, our Independent Advisory Committee concluded that these were not enough to make these treatments a cost-effective use of NHS resources in the mild stages of the disease.

He continued: "NICE was not asked by the Court of Appeal to carry out a new appraisal of these treatments. However, we operate a process of regularly reviewing our guidance to take into account any new evidence and as long as no appeals are received a review can start as soon as possible.

"The decisions NICE makes are amongst the most difficult in public life and we will continue to work hard to ensure that our decision-making process is robust and transparent and works in the best interests of everyone who relies on the NHS for their care. Alzheimer's disease is one of the most distressing and debilitating disorders but drug treatment is not the only option for these patients. This is why we have published a clinical guideline on the management of dementia (including Alzheimer's disease) which outlines the package of medical and social care that should be available for people with dementia and their carers, including social, medical and psychological treatment from early detection through to end of life."

Source
NICE