DoH may overturn NICE decision

The Department of Health is making plans to overrule a decision by the National Institute for Clinical Excellence (NICE) to scrap the availability of certain Alzheimer's disease treatments through the NHS.

Last week, NICE released interim guidance stating that cholinesterase inhibitors used to treat Alzheimer's disease - including Aricept, Exelon and Reminyl -should not be available routinely on the NHS. Despite clearing the drugs for use through the health system in 2001, the guidance claimed that the drugs failed to improve sufferer's quality of life and were not cost-effective.

However, the DoH has said that it will ask NICE to rethink its decision. ìIn view of the public concern over the draft proposals, the government will want to ensure that all aspects have been fully considered,î it stated.

ìIn particular, the DoH will be asking NICE whether the wider social implications of not approving the drugs' use have been fully taken into account, especially the benefits and costs to carers as well as patients.î

Health minister, Stephen Ladyman, has also voiced his concerns on the decision. He told the Observer: ìThey [NICE] have to look at the wider impact of this decision. It may well be that once they have looked at the extra evidence they will come to a different decision.î

His comments were backed by Dr Paul Hooper, managing director of Eisai, which markets Aricept: ìIt is comforting to know that Stephen Ladyman shows a lot more common sense than the NICE appraisal committee that came up with this perverse proposal,î he said.

Although the DoH's plans to intervene were welcomed by Alzheimer's charities, which are planning mass protests outside parliament this week, others remained concerned that NICE's position could be undermined by a u-turn decision.

Professor Alan Maynard, a leading health economist from the University of York, said that if NICE's decision was overruled, it would ìundermine the whole mechanismî and suggest that the body was ìseriously deficientî.

ìThe reality is that if you put money into things that are of no, or very marginal, benefit, you are denying other patients treatments that could provide greater benefits,î he added.