UPDATE: UK policy change on Alzheimer's disease drugs meets with mixed response

The ruling by the UK's National Institute for Health and Clinical Excellence (NICE) for the treatment of Alzheimer's disease (Marketletters passim) has been met with mixed feelings by pharmaceutical companies and patients alike. Alzheimer Europe, the Luxembourg-based campaign group, described the NICE initiative as "discri-minatory" whilst welcoming the partial reversal of an earlier policy, which had ruled out the use of three drugs. A fourth drug, Forest Laboratories' Namenda/Axura (memantine) remains off the National Health Service's list of approved drugs, because the NICE does not consider its medical benefits are sufficent to warrant the cost.

Swiss-based pharmaceutical major Novartis described the NICE announcement as "a significant step forward from the preliminary guidance issued in March 2005," which had ruled out all four treatments for new cases of AD. However, the firm expressed "concerns and disappointment on the denial of treatment for patients with mild Alz-heimer's disease." Similar views were echoed by the Association of British Pharmaceutical Industry, UK-based specialist drug firm Shire, Japan-based Eisai (which manufactures Aricept) and global drugs behemoth Pfizer. The drugs that are approved for "moderate" sufferers of AD are Eisai/Pfizer's Aricept (donepezil), Novartis' Excelon (rivastigmine) and Johnson & Johnson/Shire's Reminyl (galantamine).

The most controversial part of the NICE's ruling, presented on January 23 in the form of an Appraisal Consultation Document, is that neither early nor later stage sufferers of AD will be offered the drugs. Alzheimer Europe, in a statement, expressed concern that: "this decision will discri-minate against people with Alzheimer's disease in the UK, by refusing them treatment available to patients in other European countries."