NICE draft decision - what does it mean for people with dementia?

The National Institute for Clinical Excellence (NICE) published new guidance on the availability of Alzheimer's drugs on the NHS in England and Wales in 2011. These are drugs that are licensed to treat Alzheimer's disease, but not other forms of dementia.

Alzheimer's Society has campaigned for many years for people to have access to these drugs - but what does this guidance mean for people with dementia?

What are these drugs and how do they help?

No drug treatments can provide a cure for Alzheimer's disease. However, drug treatments have been developed that can improve symptoms, or temporarily slow down their progression, in some people.

There are four Alzheimer's disease drugs. Three drugs - Aricept, Exelon and Reminyl - are licensed for the early and moderate stages of Alzheimer's disease. They work by preventing the breakdown of a chemical messenger in the brain. All three of these drugs work in a similar way, but one might suit an individual better than another.

The fourth drug - Ebixa - is licensed for the moderate to severe stages of dementia. This works by blocking another messenger chemical called glutamate. Too much glutamate is produced when brain cells are damaged by Alzheimer's disease and this causes the cells to be damaged further.

These are the only drugs available for treating Alzheimer's disease. They are not licensed for people with other forms of dementia. Find out more about these drugs by reading our factsheet.

What does the guidance from NICE say?

People with Alzheimer's disease have been denied full access to these drugs since 2007 when NICE restricted their availability on the NHS to people in the moderate stages.  NICE ruled that the drugs were clinically effective but not cost effective.

NICE has published new guidance which removes these restrictions, meaning that people with Alzheimer's disease in England and Wales should have access to the drugs available. Three anticholinesterase drugs (Aricept, Exelon and Reminyl) will be available from the NHS for people in the early to moderate stages. A fourth drug (Ebixa) will be available for people in the late stages, and in the moderate stages if they cannot tolerate the anticholinesterase drugs.  This guidance came into force in June 2011.

What does this decision mean for people with dementia?

Primary Care Trusts now have a legal duty to provide funding for the drugs for their patients. This means that people with dementia and their families should discuss appropriate medication with their GPs and specialists to understand if they would have any benefit.

Alzheimer's Society considers this a momentous decision for people with dementia. We estimate that the drugs have benefits for about half the people who take them. The extent to which they help relieve symptoms and improve quality of life varies but for some people they can have a huge impact, helping them continue hobbies and live independently for much longer than they would be able to without the drugs.  

What if I don't have Alzheimer's disease, but another form of dementia?

These drugs are only licensed for people with Alzheimer's disease, not other forms of dementia.  However, there is a range of support available for people with all forms of dementia, and you should speak to your GP to ensure you have access to everything you are entitled to. Please visit the Living with dementia pages of this website to find out more.

What will Alzheimer's Society do now?

Our access to drugs campaign continues.  We still need to ensure that everyone has access to the treatments they need.  Find out more on our campaign page.