This final guidance from NICE will recommend to the NHS in November that donepezil, galantamine and rivastigmine should only be considered as options for treatment of people with moderate Alzheimer’s disease. Memantine is only recommended as part of clinical studies for people with moderate-severe to severe Alzheimer’s disease.
In 2001 NICE guidance recommended that the Alzheimer’s drugs should be used as a standard treatment. However, a further appraisal in 2005 resulted in NICE stating that the drugs should be restricted as the cost of treating these patients was not supported by the available evidence.
The pharmaceutical manufacturers were asked to present further evidence of the effectiveness of these treatments in patients with mild Alzheimer’s disease.
Andrew Dillon, NICE chief executive, said: ‘Alzheimer’s is a cruel and devastating illness and we realise that today’s announcement will be disappointing to people with Alzheimer’s disease and those who treat and care for them. But we have to be honest and say that based on all the evidence, including data presented by the drug companies themselves, our experts have concluded that these drugs do not make enough difference for us to recommend their use for treating all stages of Alzheimer’s disease.’
Pfizer and Eisai, manufacturers of donepezil, are reported to be considering a judicial review of the decision.