Alzheimer drugs rationing continues despite NICE guidelines
pharmafile | October 21, 2003 | News story | |Â Â Â
Alzheimer's patients in a quarter of all health authorities are still not receiving the latest medicines despite NICE guidance being in place for nearly two years.
The study, carried out in February and March, found only 76% of health authorities were providing formal funding for the acetylcholinesterase inhibitor drugs, Aricept, marketed by Eisai and Pfizer, Exelon (Novartis) and Reminyl (Shire).
The remaining 17% capped budgets for the drug, and a further 3% restricted the numbers of patients eligible to receive them.
Simon Denegri, Assistant Chief Executive of the Alzheimer's Society, said: "It is evident that these drugs are still being rationed in various ways; by restricting access, limiting budgets or applying narrow criteria for prescribing. With the benefits of these drugs to many people with dementia now being clear, it is a tragedy that people continue to be denied access to them."
The survey shows an improvement on the results of an earlier study conducted in October 2000 before NICE issued its guidelines, when just half of HAs were paying for the drugs.
David Taylor, Chief Pharmacist at the Maudsley Hospital, London and colleague Shubra Mace, Senior Clinical Pharmacist conducted the survey, receiving 63 replies from 91 HA pharmaceutical advisers in England and Wales.
One in ten said they did not believe NICE guidelines were being followed by their HA, with almost a quarter citing working across organisational boundaries as a major obstacle to progress.
NICE's guidance stipulates that diagnosis must be carried out in specialist clinics, which has contributed to the slow pace of change. GPs are allowed to take over prescribing once 'shared-care' protocols are established but the survey found that only half of the HAs had set up this system.
David Taylor said the problems have not disappeared since reform of the NHS on 1 April.
"Although our survey looked at Health Authorities, which have now ceased to exist, the issues remain exactly the same for Strategic Health Authorities that have replaced them and the Primary Care Trusts who have to make such decisions on the ground."
The Alzheimer's Society said complaints about access to the drugs had dropped in recent months, but cases of people fighting for treatment are still coming to light.
