One cheer for Alzheimer drugs decision

EMBARGO: 00.01 23 JANUARY 2006
To: News/Health/Community Editors

Following pressure from Alzheimer Scotland and other dementia organisations, on 23rd January, the National Institute for Clinical Excellence (NICE) announced that it has changed its earlier recommendations that the Alzheimer drugs (donepezil, galantamine and rivastigmine) should not be available on the NHS.

The decision has been greeted with muted enthusiasm by Alzheimer Scotland, as the drugs will only be prescribed to people with moderate Alzheimer’s disease and not those diagnosed as in the mild stage of the illness.

Jim Jackson, Chief Executive of Alzheimer Scotland says, “The positive side of NICE’s decision is that the anticholinesterase inhibitors will still be available. However, by prescribing these drugs to people with moderate Alzheimer’s disease only, there is a risk that we lose the momentum for early diagnosis and that some people who would have benefited from drug treatment lose out.”

Assessment of patient suitability will be dependent on the Mini Mental State Examination (MMSE) and drugs prescribed if the patient scores between 10 and 20 points. If after 6 months, the person with Alzheimer’s scores under 10 points, NICE recommends that drug treatment should be withdrawn.

Alzheimer Scotland argues that decisions on whether to prescribe or withdrawal treatment should not depend on MMSE scores.

Mr Jackson continues, “We are concerned that NICE has placed too much emphasis on MMSE scores, which may over-ride other clinical benefits. MMSE scores do not provide accurate assessment of quality of life in people with Alzheimer’s disease.
Furthermore, if a person with the illness is taken off medication there can sometimes be a marked deterioration in their condition. That person should retain their right to treatment regardless of his or her MMSE score.”

Alzheimer Scotland will be campaigning for the latest drugs recommendations from NICE to be modified to widen access to these treatments. We will also be asking NHS QIS to make sure that the Scottish translation of NICE’s final recommendations are for the benefit of people with Alzheimer’s and their carers throughout Scotland.
Interviews can be arranged with Jim Jackson, and people with dementia and their carers who are benefiting from the Alzheimer drugs.

Please give our Freephone 24hr Dementia Helpline telephone number: 0808 808 3000 and our website address: www.alzscot.org at the end of articles.

Contact details:

Sarah Bromley, PR & Marketing Manager, tel 0131 243 1453, mob 07966 458 869, sbromley@alzscot.org
Jim Jackson, Chief Executive, tel 0131 243 1453, mob 07747 025 041, jjackson@alzscot.org
Kate Fearnley, Public Policy Director, tel 0131 243 1453, mob 07791028 317, kfearnley@alzscot.org

Notes for Editor:

Further recommendations made by NICE:

• Memantine is no longer recommended for people with moderate to severe Alzheimer’s disease in England and Wales. Memantine has not been available in Scotland since January 2004.
• People with Alzheimer’s who are currently receiving donepezil, galantamine, rivastigmine, and memantine whether as routine therapy or as part of a clinical trial, may be continued on therapy until they, their carers and/or specialist consider it appropriate to stop.

Dementia affects approximately 63,000 people in Scotland.

• 34,640 have Alzheimer’s disease
• 10,400 have mild Alzheimer’s disease
• 14,600 have moderate Alzheimer;s disease

Alzheimer’s disease is the main form of dementia. The second most common is vascular dementia. As yet there is no cure.

Alzheimer Scotland is Scotland’s foremost voluntary organisation working for people with dementia and their carers. It:

• speaks out for the rights and concerns of people with dementia and their carers;
• operates services on over 60 sites throughout Scotland providing practical services such as day, evening and weekend centres, home care and befriending and carers' support services;
• provides the 24 hour national freephone Dementia Helpline (0808 808 3000);
• provides the website www.alzscot.org;
• supports a network of over 40 carers' support groups;
• provides information to carers, professionals and people with dementia;
• publishes leaflets, booklets, reports and a quarterly newsletter keeping carers and professionals up-to-date
• has a research programme.