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The high price tag of two groundbreaking Alzheimer’s drugs has led to a decision against their availability on the NHS due to the minimal benefits they offer. These medications, donanemab and lecanemab, are the first to slow the progression of the disease, potentially extending the time patients can live independently. However, the National Institute for Health and Care Excellence (NICE) has deemed them too costly for the limited advantages they provide, with concerns that funding them could result in cuts to other essential services.
Donanemab and lecanemab work by assisting the body in clearing a harmful protein that accumulates in the brains of individuals with Alzheimer’s. While these drugs do not halt or reverse the disease, they have shown in clinical trials to slow the loss of brain function. Despite being hailed as a significant scientific achievement due to altering the course of Alzheimer’s, a debate has arisen surrounding the drugs’ affordability and the actual impact of their benefits.
The official cost in the US for these drugs ranges from £20,000 to £25,000 per patient per year, with estimates suggesting that up to 70,000 individuals in England with early-stage dementia could qualify for treatment. The potential yearly cost of providing these medications alone could be as high as £1.5 billion, not including additional expenses such as administering the drugs through spinal infusions and frequent brain scans to monitor adverse effects. Experts remain divided on the drugs’ efficacy, with concerns raised about the marginal improvements they offer versus the significant financial resources required.
Despite hopes of extending the time individuals with mild dementia can remain independent and engaged in daily activities, the decision not to fund these drugs was expected. Concerns over the modest benefits and substantial costs associated with the medications led to the conclusion that they were not a viable investment for the healthcare system. While the pharmaceutical companies involved have expressed their intention to appeal the decision, the lack of substantial evidence supporting the drugs’ cost-effectiveness has prompted NICE to uphold their initial ruling against their funding, potentially shifting focus towards other more impactful dementia treatments and care approaches
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