Healthcare: At a Glance - NICE provokes Alzheimer's anger

Do you mean last week's U-turn, 'a return to a dark age of dementia care'?

That's certainly the Alzheimer's Society's view. NICE provisionally decided last week to reverse its 2001 recommendation for the UK's four anti-Alzheimer's drugs - Aricept (Pfizer/Eisai), Exelon (Novartis), Reminyl (Shire) and Ebixa (Lundbeck) - to be made available on the NHS. And make no mistake, manufacturers and their PR agencies were pretty shell-shocked.

But this isn't a cut-and-dried decision?

Responses to NICE must be in by 25 March and it will then make a final recommendation. So the four pharma companies' in-house PROs plus Clew Communications (Aricept), The Workhouse (Exelon), GCI Healthcare (Reminyl) and Athena Medical PR (Ebixa) are concentrating immediate efforts on that response, while continuing media relations, medical education and communication with patients.

What are their main PR battlegrounds?

NICE's reasoning, that the drugs are not cost-effective, is to be attacked as 'perverse'. PROs will bid to rubbish the financial model used for determining the effectiveness of treatment in this case and insist that the research data it has used to reach the decision is 'highly selective'. Expect figures to be aired, such as the NHS spending one third more on Viagra prescriptions than dementia, for example. Although a small percentage of people suffer from Alzheimer's, the UK has an ageing population and incidence of the disease rises sharply after 60.

But none of these drugs offers a cure, do they?

No, but they all offer relief - and it is not only manufacturers saying this, it is senior clinicians and patient groups, too. PROs' arguments will run that, with later diagnosis, and no drug treatment, sufferers' deterioration may be faster, which means they are likely to be institutionalised more quickly, thus raising taxpayers' costs anyway.

What's the current situation?

A patient on a course of any of these drugs is to be allowed to continue taking them. NICE will take its final decision later this year - but one experienced PRO says there is widespread suspicion that NICE plans to dig its heels in and the regulator is ready for things to get 'bloody'.

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