A decision by NHS authorities to block access to a promising new Alzheimer’s treatment has sparked frustration among patient advocacy groups.
Donanemab, a breakthrough drug shown to slow the progression of the disease, received approval from the UK medicines regulator, the Medicines and Healthcare products Regulatory Agency (MHRA), but won’t be available to most NHS patients due to cost concerns.
Limited Access Despite Approval
While donanemab has been hailed as a “new hope” in the fight against dementia, the NHS’s spending watchdog, the National Institute for Health and Care Excellence (NICE), ruled that the benefits do not justify the high price tag.
The drug, which costs £25,000 annually, will only be accessible to those who can afford it out of pocket, as it is unlikely to be covered by health insurance.
Patient groups and charities expressed deep disappointment, describing the decision as a significant setback.
Campaigners estimate that around 70,000 people in England who could have benefited from the treatment will now miss out.
This is the second time NICE has rejected an Alzheimer’s treatment this year, following its decision to block lecanemab in August on similar grounds.
Alzheimer’s Research UK and Charities Respond
Hilary Evans-Newton, CEO of Alzheimer’s Research UK, voiced frustration over the announcement, highlighting that two new treatments are now licensed in the UK, but NHS patients will be unable to access them.
While neither donanemab nor lecanemab is a cure, trials have shown that these drugs can slow the cognitive decline associated with Alzheimer’s, offering more than just symptom management.
Evans-Newton also warned of the growing impact of dementia on the NHS, with dementia remaining the leading cause of death in the UK.
As the population ages, the number of families affected is expected to rise, putting increasing pressure on healthcare resources.
How Donanemab Works
Donanemab works by targeting amyloid, a harmful protein that builds up in the brains of Alzheimer’s patients and interferes with brain function.
Known as amyloid immunotherapy, the drug has been shown to slow disease progression by as much as 35% in clinical trials.
Patients in these trials received the drug through monthly infusions for 18 months, but the additional monitoring required, including regular brain scans, adds to the overall cost.
Despite the promising results, NICE officials, including director Helen Knight, explained that the drug’s benefits—slowing cognitive decline by four to seven months—were not enough to justify its price.
NICE’s cost-effectiveness threshold is significantly lower than the estimated cost of donanemab, leading to the decision to block its availability on the NHS.
The Future of Alzheimer’s Treatments
Looking ahead, NICE has indicated that more Alzheimer’s treatments are in development, with 27 drugs potentially up for evaluation in the coming years.
The growing number of potential treatments presents a critical opportunity for the NHS to transform dementia care, according to Evans-Newton, but progress remains stalled due to the current cost barrier.
Professor Fiona Carragher of the Alzheimer’s Society echoed calls for more government investment, stressing the need for early diagnosis and access to treatments that can slow disease progression.
Without this investment, the growing burden of dementia will continue to strain both families and healthcare resources.
Cost of Dementia in the UK
The overall financial impact of dementia on the UK is staggering, with costs currently estimated at £42 billion annually.
This includes the lost earnings of unpaid carers and other related expenses.
With the UK’s ageing population, these costs are expected to skyrocket to £90 billion in the next 15 years.
Meanwhile, recent developments such as cheap blood tests that can help diagnose Alzheimer’s earlier could offer a glimmer of hope.
These tests, currently being trialed by researchers in Oxford and London, could revolutionize early detection and improve access to treatments.
However, without government action to address the cost barrier, many patients may still find effective treatments out of reach.
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