Benefits Of 2 Alzheimer’s Treatments Remain Too Small To Justify The Additional Cost To The NHS
National Institute for Health and Care Excellence (NICE) has concluded that the benefits from donanemab (also called Kisunla and made by Eli Lilly) and lecanemab (also called Leqembi and made by Eisai) – remain too small to justify the additional cost to the NHS, following a consultation with an independent committee.
This means the medicines should not be provided on the NHS as they are not good value for money.
Last month the appraisal committee met to consider new information submitted as part of its additional consultation on negative draft recommendations for donanemab and lecanemab.
The committee’s conclusion in final draft guidance published today remains that neither drug can be recommended for treating mild cognitive impairment or mild dementia caused by Alzheimer’s disease.
This is because, based on all the evidence submitted, they still do not demonstrate sufficient benefit for their high cost, including the cost of administering them. The treatments have been shown to delay progression from mild to moderate Alzheimer’s by 4-6 months but the overall costs of purchasing and administering the drug remain high and the benefits too small.
For NICE to be able to approve a medicine for use in the NHS it must not only represent a step forward in treatment, but it must also represent a good use of NHS resources and taxpayers’ money. These treatments they conclude do not do that.
We have done everything we possibly can to try and achieve a positive outcome in our assessments of these treatments, including providing an additional opportunity for new evidence to be submitted.
Helen Knight, director of medicines evaluation at NICE said:
“We have done everything we possibly can to try and achieve a positive outcome in our assessments of these treatments, including providing an additional opportunity for new evidence to be submitted.”
Helen continued: “The committee accepted that any slowing of the disease getting worse would be meaningful for people with mild cognitive impairment or mild dementia caused by Alzheimer’s disease and their carers because it could mean more time socialising, driving and being independent, so needing less help day-to-day from family members.
“The committee accepted that any slowing of the disease getting worse would be meaningful for people with mild cognitive impairment or mild dementia caused by Alzheimer’s disease and their carers because it could mean more time socialising, driving and being independent, so needing less help day-to-day from family members.
“However, the committee concluded the small benefits of donanemab and lecanemab shown in the clinical trials and the lack of long-term evidence of effectiveness, together with the substantial resources the NHS would need to commit to the treatments means if they were approved they could displace other essential treatments and services that deliver significant benefits to patients.”
Professor Fiona Carragher, Alzheimer’s Society’s Chief Policy and Research Officer, said:
“There is no doubt that today’s decision is a setback for people with Alzheimer’s disease. It is highly disappointing that we are in a situation where treatments that slow the progression of the condition are not available on the NHS.
“The reality we’re faced with is that these treatments remain out of reach of both the NHS and most eligible people with Alzheimer’s disease. In other diseases like cancer, treatments have become more effective, safer and cheaper over time. It’s essential we see similar progress in dementia.
“The fact is, even if donanemab and lecanemab were made available on the NHS tomorrow, too many patients wouldn’t be able to access them because the health system isn’t ready to deliver them. The science is flying but the system is failing.
“What we need now is for the UK government to commit to the long-term investment needed to fundamentally change dementia diagnosis so that we are ready for new treatments. This relies on an early diagnosis and access to specialist diagnostic tests, yet currently a third of people with dementia don’t have a diagnosis at all.
“The needs of people with dementia have long been overlooked and this cannot continue. We are heading towards a future where disease-slowing treatments reduce the devastating impact of dementia, and we cannot afford to delay preparing the NHS for them.”
