Final NICE Appraisal Recommends Improved Access to Treatment and Care of People With Early Alzheimer's Disease

By Eisai Europe Limited And Pfizer Limited, PRNE
Sunday, January 16, 2011

New Survey Shows More Than Half (57.9%) of GPs Likely to Recall Mild Alzheimer's Patients Previously Denied Treatment for Reassessment

LONDON, January 18, 2011 - The National Institute for Health and Clinical Excellence (NICE) today
published its final appraisal determination containing final recommendations
on the use of specific treatments for Alzheimer's disease. The new ruling
means Alzheimer's patients will now have access to treatment from the
earliest stage of the disease.[1]*

A survey conducted among general practitioners across the UK has
suggested that the new recommendations will give Doctors[2] a strong reason
to diagnose and treat this devastating disease early. It highlighted that
nearly two thirds (64.1%) of GPs believe that their detection and diagnosis
of mild Alzheimer's disease patients will improve as a result of the NICE
guidance. Until now diagnosing the condition early has been difficult for
GPs, as the guidelines previously recommended treatment only for patients
with moderate or severe Alzheimer's disease. 70.2% of GPs surveyed believe
that their management of Alzheimer's disease will change as a result of the
new guidance with over half (57.9%) of GPs stating that they would be likely
to recall patients with mild Alzheimer's previously denied treatment for
reassessment. This should help more people with early disease get access to
specialist care by being referred to a memory service for assessment. A total
of 40.7% of doctors also thought that their prescribing of AChEIs would
change as a result of the NICE recommendations.

"This is great news for people with Alzheimer's disease and
their families because we will now be able to offer effective drug treatment
in mild, moderate and severe Alzheimer's disease. For example, patients with
mild disease will at last be able to get access to early, cost-effective
treatment at the point of diagnosis - treatment that can potentially help to
relieve the symptoms in these patients", says Professor Roy Jones from The
Research Institute for the Care of Older People (RICE), Royal United
Hospital, Bath, UK. "Previously it was difficult to see patients with mild
disease and ask them to come back when their condition worsened before we
were able to prescribe drugs that could improve their symptoms. This new
ruling will help keep patients as independent as possible for as long as

The new survey data also revealed that, unfortunately 29.6 % of GPs
surveyed were unaware of the preliminary recommendations published by NICE on
the use of AChEIs in patients with Alzheimer's disease and 55.5% believe that
there are inadequate protocols / materials in place to effectively help them
diagnose people showing early signs of disease. In addition, the survey
revealed that 86.7% of GPs believe that families and carers of patients with
Alzheimer's disease do not have adequate support to recognise and manage the
early signs of the disease. It is vital that Alzheimer's disease is diagnosed
as early as possible, as having an early diagnosis, starting treatment and
putting lifestyle modifications in place in the early stages of the disease
can help individuals prepare for the future.[3] Greater awareness is needed
amongst patients, carers and GPs of the early treatment options now available
to them which could lead to better outcomes for the patient and carers.

*Additional information on the NICE guidance1

1.1 The three acetylcholinesterase (AChE) inhibitors (donepezil,
galantamine and rivastigmine) are recommended as options for managing mild to
moderate Alzheimer's disease under all of the conditions specified in 1.3 and

1.2 Memantine is recommended as an option for managing Alzheimer's
disease for people with: moderate Alzheimer's disease who are intolerant of
or have a contraindication to AChE inhibitors or severe Alzheimer's disease.

1.3 Treatment should be under the conditions specified in 1.3.

    - Only specialists in the care of patients with dementia (that is,
    psychiatrists including those specialising in learning disability,
    neurologists, and physicians specialising in the care of older people)
    should initiate treatment. Carers' views on the patient's condition at
    baseline should be sought.

    - Treatment should be continued only when it is considered to be having a
    worthwhile effect on cognitive, global, functional or behavioural

    - Patients who continue on treatment should be reviewed regularly using
    cognitive, global, functional and behavioural assessment. Treatment
    should be reviewed by an appropriate specialist team, unless there are
    locally agreed protocols for shared care. Carers' views on the patient's
    condition at follow-up should be sought.

1.4 If prescribing an AChE inhibitor (donepezil, galantamine or
rivastigmine), treatment should normally be started with the drug with the
lowest acquisition cost (taking into account required daily dose and the
price per dose once shared care has started). However, an alternative AChE
inhibitor could be prescribed if it is considered appropriate when taking
into account adverse event profile, expectations about adherence, medical
comorbidity, possibility of drug interactions and dosing profiles.

For the full guidance, please visit:

Currently, there are around 820,000 people living with Alzheimer's and
other dementias in the UK,[4] including an estimated 575,000 sufferers in
England and 37,000 in Wales.[5] Alzheimer's disease is the most common form
of dementia, affecting 62% of dementia patients in the UK.[5] This
irreversible, progressive brain disorder gradually destroys memory, reasoning
and thinking skills, and may eventually leave patients unable to carry out
even the simplest tasks.[6] Alzheimer's disease has impacts in many ways
including physical, mental, nursing, medical and social impacts.[1] Despite
its burden, Alzheimer's remains a relatively overlooked disease. Just 2.5% of
the government's medical research budget is devoted to dementia; in contrast
a quarter is allocated to cancer research.[7]

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[1] National Institute for Health and Clinical Excellence, Final
Appraisal Determination - Donepezil, galantamine, rivastigmine and memantine
for the treatment of Alzheimer's disease (review of NICE technology appraisal
guidance 111)

[2] Opinion Health survey data. Total sample size was 200 GPs in the UK.
Online internet-based survey fieldwork undertaken between 13th - 16th
December 2010
. Eisai Europe and Pfizer Ltd. Data on File

[3] Doraiswamy PM, Steffens DC, Pitchumoni S, Tabrizi S. Early
Recognition of Alzheimer's disease: what is consensual? What is
controversial? What is practical? J Clin Psychiatry. 1998;59 (suppl.

[4] Alzheimer's Research Trust -Dementia 2010. Available at: Last accessed Jan

[5] Alzheimer Society. Available at: Last
accessed Jan 2011

[6] National Institute on Aging (NIA). Alzheimer's Disease Factsheet. NIH
Publication No 08-6423. Reprinted February 2010

[7] Alzheimer's Research Trust. Available at: Last accessed Jan 2011

Benjamyn Tan / Laura Craggs, Tonic Life Communications, +44(0)20-7798-9262 / +44(0)20-7798-9260, Benjamyn.tan at / laura.craggs at, Eisai Europe Ltd - Cressida Robson: +44(0)845-676-5318, Pfizer Press Office: +44(0)845-3008033

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