NHS Rejects Two Alzheimer's Treatments Due to High Cost and Modest Benefits

Strategic Insights -

The National Institute for Health and Care Excellence (Nice) has reaffirmed its decision to reject two Alzheimer's treatments, donanemab and lecanemab, citing their high cost and modest benefits for patients. The treatments, developed by Lilly and Eisai, respectively, target a known cause of Alzheimer's disease, amyloid, and have shown promise in slowing down cognitive decline. However, Nice concluded that the benefits of the treatments are not sufficient to justify the substantial resources required to provide them, and their rejection has been met with disappointment from charities and drug firms.

Key Takeaways:

  • Donanemab and lecanemab are targeted antibody drugs designed to slow down cognitive decline in Alzheimer's patients by binding to amyloid, a protein that builds up in the brains of people living with Alzheimer's disease.
  • The treatments have been shown to delay progression from mild to moderate Alzheimer's by four to six months in clinical trials.
  • Nice has accepted that the treatments offer modest benefits for patients, particularly in slowing down cognitive decline, but concluded that the costs of providing them would be too great, potentially displacing other essential treatments and services.
  • The decision has been met with disappointment from charities and drug firms, with Alzheimer's Society's chief policy and research Officer, Professor Fiona Carragher, describing it as a "painful setback" for patients.
  • The rejection of the treatments has been fueled by concerns about their high cost, estimated to be between £500 million to £1 billion per year for the NHS.
  • Drug firms have announced plans to appeal the decision, with Lilly stating that it will contest the decision on the grounds that it was unreasonable based on the evidence submitted.

Statistics:

  • The treatments have been shown to slow down cognitive decline by more than 20% in clinical trials (donanemab).
  • Lecanemab has been shown to successfully remove protein build-up from the brains of people living with early Alzheimer's disease, leading to a 27% slowing in the decline of thinking and memory skills.
  • A reformulation of lecanemab is being developed so it can be administered subcutaneously under the skin.
  • Side-effects of the drugs can be serious, including brain bleeds and risk of death.

Sources:

  • "NHS rejects Alzheimer's treatments due to cost" (BBC News).
  • "Nice rejects Alzheimer's treatments for low benefits" (The Guardian).
  • Alzheimer's Society (Source).
  • Nice (Source).