Alzheimer’s Drugs are Too Pricey for NHS

Breakthrough Alzheimer’s Drugs are Too Pricey

Two breakthrough Alzheimer’s drugs have been deemed far too expensive, for too little benefit, to be offered on the NHS. The medicines are the first to slow the disease, which may give people extra time living independently.

The BBC News Service is reporting that the National Institute for Health and Care Excellence (NICE) concluded they were a poor use of taxpayers’ money and said funding them could lead to other services being cut.

Campaigners say it is a disappointment, but other dementia experts have also supported the decision.

The two drugs, donanemab and lecanemab, both help the body clear a gungy protein that builds up in the brains of people with Alzheimer’s disease.

The medicines do not reverse or even stop the disease, rather brain power is lost more slowly with treatment.

Clinical trials of these drugs were celebrated as a scientific triumph as they showed, for the first time, it was possible to change the course of Alzheimer’s. But since then a row has developed over the cost of the drugs and how meaningful the benefit is.

The official price in the US is £20,000-£25,000 per patient per year. What the NHS would pay is confidential.

Around 70,000 people in England with mild dementia would have been eligible, potentially putting the bill in the region of £1.5bn a year for the drugs alone.

NHS resources, including infusing the drugs every two-to-four weeks and frequent brain scans to manage dangerous side effects, would also massively ramp up the cost.

The benefit of the drugs is also debated. They potentially delay the transition from mild to moderate dementia by four-to-six months. That could mean more time without needing daily care, driving, being present for significant family events and socialising.

But Prof Rob Howard, from University College London, said real-world benefits “were too small to be noticeable”. In trials of lecanemab, patients were better off by 0.45 points, on an 18-point scale ranging from healthy to severe dementia. Yet he said the cost would “have been close to the cost of a nurse’s salary for each treated patient”.

The decision not to fund the drugs is not a surprise. The first assessment last year concluded they were not cost-effective.

Helen Knight, director of medicines evaluation at NICE, acknowledged the latest news would be “disappointing” but said the benefits were “modest” at best while requiring “substantial resources”.

“If they were approved they could displace other essential treatments and services that deliver significant benefits to patients,” she said.