The decision by the National Institute for Health and Clinical Excellence (NICE) to extend the availability of donepezil, galantamine, rivastigmine and memantine for Alzheimer's disease has been influenced by a review of research evidence produced by researchers from the Peninsula Technology Assessment Group, part of the Peninsula College of Medicine and Dentistry.
A previous appraisal by NICE of these drugs in 2004 approved the use of donepezil, galantamine and rivastigmine for people with moderate Alzheimer's disease, while the use of memantine was restricted to clinical trials.
As part of its ongoing review of its previous decisions, NICE requested a review of new evidence which was carried out by PenTAG, which is independent of NICE.
The evidence showed that little had changed and that all the drugs had some effect on delaying symptom progression in Alzheimer's. PenTAG also noted the uncertainty surrounding the estimates used in the previous economic model and hence its results. A new economic model developed by PenTAG and which was calibrated differently to the model used in the previous assessment, showed the drugs to be cost-effective, although some uncertainty remains.
As a consequence, the report from PenTAG was a key piece of evidence that has informed the decision by NICE's appraisal committee to extend the availability of donepezil, galantamine and rivastigmine to people with mild Alzheimer's disease, and memantine to those with severe forms of the disease.
Professor Chris Hyde from PenTAG commented: "Alzheimer's disease and dementia are a growing problem for the UK. The Alzheimer's Society estimates that there are 750,000 people with dementia in the UK today, and that this figure will grow to over one million by 2025. The costs associated with the disease are huge, with over 60,000 deaths attributed to dementia and a national financial cost to the country of £20 billion. Our work for NICE allows a rigorous and independent re-assessment of the balance of research evidence for additional patient benefits against the extra costs to the NHS of providing different treatments."