Lyndsay Moss: Alzheimer's 'wonder drug' fuels funds debate

THE arrival of the latest "wonder drug" is always keenly welcomed by the public and doctors alike. But with each new discovery, those who deal with financial matters in the NHS must feel a little more anxious about where the money is going to come from to pay for it.

In the latest example – a drug called rember to treat Alzheimer's – campaigners are clear the health service must start planning now to make sure funding is available in future.

One charity insider said: "The NHS should be looking ahead at this kind of development and making sure they will be able to have the levels of provision to ensure people who have the chance to benefit from this drug can receive it.

"In the long run, from what we understand of how (rember] is performing, it would prove cost-effective."

The particular problem with Alzheimer's is that there is still debate about currently available drugs – let alone ones yet to make it on to the market.

The treatments, which include donepezil and rivastigmine, were initially recommended by health watchdogs for use in patients at all stages of the disease.

But, in 2006, the National Institute for Health and Clinical Excellence (Nice) said the drugs should only be prescribed to people with moderate-stage disease. The body said the drugs, which cost about 2.50 a day per patient, did not make enough of a difference to recommend them for all patients.

Campaigners and drugs firms lost a High Court battle to make the NHS prescribe the drugs in the early stages of Alzheimer's, though Nice was told to rewrite guidance on how the disease is assessed.

In Scotland, NHS official guidance has followed the lead of Nice in not recommending the drugs in the early stages. But in practice, whether or not the drugs are prescribed has been left down to individual doctors.

Alzheimer Scotland said it had not heard of any patients being denied the treatments at an early stage although it has happened in England.

The charity source said: "We don't think that is happening in Scotland, but because that is what the official guidance says we are not totally confident it could not happen in the future.

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As for rember, which is said to slow down the progression of Alzheimer's by more than 80 per cent – the future looks promising.

"I can't believe the Scottish Medicines Consortium would turn it down," the source said. "But the NHS does need to start planning for this as early as possible."