Alzheimer's drugs decision based on flawed calculations

Published 15 January 2009

Thousands of people with early stage Alzheimer’s are being denied access to the only drugs for the disease due to fundamental flaws in the way their cost effectiveness has been calculated.

There has been widespread condemnation of the National Institute for Health and Clinical Excellence's (NICE) decision to restrict Alzheimer's drugs that cost just £2.50 a day on the NHS.

Following a ruling by the Court of Appeal in May 2008, NICE was ordered to release the health economic model used to make the decision to key stakeholders. We have reviewed the calculations and submitted a detailed analysis to NICE. We have appealed for NICE to review its decision on Alzheimer's drugs.

Neil Hunt, Chief Executive of Alzheimer's Society, says,

'We have always argued that the way NICE calculated the cost effectiveness of Alzheimer's drugs was fundamentally flawed. Now that we have examined NICE's calculations first hand and taken expert advice, Alzheimer's Society remains convinced that denying people with Alzheimer's effective drugs makes no sense.

NICE must urgently review its decision. One in three people over 65 will die with dementia; the current state of dementia care and treatment in the UK is a national scandal.'

We cannot release our full response to NICE due to NICE's confidentiality rules. However, previously we highlighted the following concerns about the way cost effectiveness is calculated:

NICE assumes everyone who starts treatment continues on it. In reality, only those who benefit from drugs would stay on them.
NICE has drastically underestimated the cost savings to the State of people receiving treatment and remaining active in the community (rather than cared for in homes or hospitals)
NICE does not take into account the full benefit drug treatment can have on a carer's quality of life.

In October 2008, the House of Lords denied NICE the right to appeal the high court decision which ordered it to release a copy of the executable model.