NICE appraisal of Alzheimer's drugs, UK

Main Category: Alzheimer's / Dementia
Article Date: 15 Mar 2005 - 17:00 PDT

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Speaking about press coverage of the Institute's technology appraisal on the use of donepezil, rivastigmine, galantamine and memantine for the treatment of Alzheimer's disease, NICE Chief Executive Andrew Dillon stated:

"The Institute would like to make it clear that contrary to recent press reports (The Observer 13 March and Daily Mail 14 March) it has not been asked or told by Ministers to reverse its advisory committee's provisional recommendations on the use of these drugs.

"Consultation on the provisional recommendations will continue until 22 March and anyone with an interest in the appraisal can comment via our web site. The advisory committee will meet in June to consider the responses received and will prepare final advice shortly afterwards.

"The Institute's methodology and process for evaluating medicines has been assessed by the World Health Organisation to be of the highest standard and the Board has full confidence in the conduct of the appraisal of the Alzheimer's drugs."

NICE has not yet issued new guidance to the NHS on the use of donepezil, rivastigmine, galantamine and memantine for the treatment of Alzheimer's disease; the final guidance is expected in October 2005. Until final guidance is issued the existing NICE guidance no. 19 continues to apply.

About NICE

1 NICE is currently consulting on the use of rivastigmine, galantamine and memantine for the treatment of Alzheimer's disease, the closing date for comments is the 22 March 2005. If you would like to comment please go to the NICE website nice.org.uk/page.aspx?o=245909.

2 NICE produces guidance in three areas of health:

-- the use of new and existing medicines and treatments within the NHS in England and Wales - technology appraisals

-- the appropriate treatment and care of patients with specific diseases and conditions within the NHS in England and Wales - clinical guidelines.

-- whether interventional procedures used for diagnosis or treatment are safe enough and work well enough for routine use - interventional procedures.

3. NICE guidance and recommendations are prepared by independent groups that include professionals working in the NHS and people who are familiar with the issues affecting patients and carers.

4. From 1 April 2005, the National Institute for Clinical Excellence will take on the functions of the Health Development Agency. The new organisation will be the National Institute for Health and Clinical Excellence (also to be known as NICE). It will be the independent organisation responsible for providing national guidance on the promotion of good health and the prevention and treatment of ill health. The web address will continue to be http://www.nice.org.uk.

About technology appraisals

5. The stakeholders involved in the appraisal are:

-- Eisai Ltd
-- Shire Pharmaceuticals LtdPatient/carer groups
-- Age Concern Cymru
-- Age Concern England
-- Alzheimer's Society
-- Carers UK
-- Carers Wales
-- CJD Support Network
-- Counsel and Care for the Elderly
-- Dementia Care Trust
-- Different Strokes
-- Help the Aged
-- Huntington's Disease Association
-- Mental Health Foundation
-- MIND
-- Network of Self Help HIV & Aids Groups
-- Neurological Alliance
-- Parkinson's Disease Society
-- Pick's Disease Support Group
-- SANE
-- Stroke Association
-- Terence Higgins Trust
-- UK Coalition of People Living With HIV and AIDS
-- Professional groups
-- British Association of Neurologists
-- British Association of Stroke Physicians
-- British Geriatrics Society
-- British Neuropsychiatry Association
-- For Dementia• Royal College of General Practitioners
-- Royal College of Nursing• Royal College of Physicians
-- Royal College of Psychiatrists
-- Royal Pharmaceutical Society

Others

-- Bath and North East Somerset PCT
-- Department of Health
-- North Tees PCT
-- Welsh Assembly Government
-- Commentators (no right of appeal)
-- British Medical Association
-- British National Formulary
-- National Collaborating Centre for Chronic Conditions
-- National Public Health Service for Wales
-- NHS Confederation
-- NHS Purchasing and Supplies Agency
-- NHS Quality Improvement Scotland

Research groups

-- Alzheimer's Research Trust
-- British Stroke Research Group
-- Cochrane Stroke Group
-- Creutzfeldt-Jakob Disease Surveillance Unit
-- Dementia Research Group and Department of Old Age Psychiatry, Institute of -- Psychiatry
-- Institute for Ageing and Health
-- Institute of Neurology

-- Research Institute for the Care of the Elderly

6. Technology appraisals are recommendations on the use of new and existing medicines and treatments within the NHS in England and Wales, such as:

a. medicines (for example, drugs)
b. medical devices (for example, hearing aids or inhalers)
c. diagnostic techniques (tests used to identify diseases)
d. surgical procedures (for example, repairing hernias)
e. health promotion activities (for example, patient education models for diabetes).

7. Our technology appraisal recommendations are prepared by an independent Committee, who include healthcare professionals working in the NHS and people who are familiar with the issues affecting patients and carers. The Committee considers the evidence on the clinical and cost effectiveness of the technology - this includes hearing the views of, and evidence from, clinical health professionals, experts and patients.

8. NHS organisations in England and Wales have to make the resources and facilities available to enable NICE guidance to be implemented. In January 2002 the Government announced a legal obligation for the NHS to provide funding for treatments and drugs recommended by NICE as a part of its technology appraisals work programme.

9. NICE is currently in the process of developing a clinical guideline on the management of dementia, including use of antipsychotic medication in older people. This will address the wider issue of care of patients with dementia (including Alzheimer's disease). This guideline is expected to be published in February 2007. More details can be found from nice.org.uk/page.aspx?o=63355.

National Institute for Clinical Excellence (NICE)
MidCity Place
71 High Holborn
London
WC1V 6NA
Tel: 020 7067 5800 (switchboard)
Fax: 020 7061 9815 (fax)
http://www.nice.org.uk Please note that from 1 April 2005 NICE will join with the Health Development Agency to become the new National Institute for Health and Clinical Excellence (also to be known as NICE). The web address for the new organisation will continue to be http://www.nice.org.uk and contact details will remain unchanged.

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