U.K.: Fresh Look At The Shameful New Rules on Alzheimer's

Limiting the use of drugs like Aricept (donepezil), Reminyl (galantamine) and Exelon (rivastigmine) will hurt millions of families reports Thomas Stuttaford, The Times LONDON, England (The Times), May 29, 2006: In her youth, Elizabeth Taylor embodied the Hollywood ideal; an ideal, so far as she was concerned, that was shared by most of the young men of her generation. Taylor first hit the headlines in 1944 when she starred in National Velvet, and she played opposite Richard Burton in the name roles in Antony and Cleopatra. Sad as it is to read that she now has Alzheimer’s disease, it shouldn’t occasion any surprise. In England and Wales a new case is diagnosed every quarter of an hour. Although its incidence varies to some extent according to educational background, existing level of social participation and such clinical factors as high blood pressure or a past history of cerebral damage, the accepted rule is that Alzheimer’s disease, and other forms of dementia, can affect anybody regardless of class and background. Elizabeth Taylor was born in 1932. At the age of 65, only 3 per cent of the population suffer from Alzheimer’s; between the ages of 75 and 84 this figure rises to 18.7 per cent; after the age of 85, 47.2 per cent of us show symptoms. Another way of analysing these figures is that once over the age of 65 the prevalence of Alzheimer’s disease doubles with every five-year increase in age. Alzheimer’s already affects most families in the country; now that people are living longer it won’t be long before nearly everyone will have personal experience of someone whose life is affected. Alzheimer’s is the most common form of dementia and affects about 450,000 people across this country. NICE (the National Institute for Health and Clinical Excellence) is due to report this week on the use of drugs to treat Alzheimer’s. The organisation has been reconsidering its initial decisions bearing in mind the uproar they caused. These first recommendations were that NHS patients should be granted access to the drugs Aricept (donepezil), Reminyl (galantamine) and Exelon (rivastigmine) only once they have reached the stage of moderate Alzheimer’s disease. This polite medical euphemism underrates the problems that patients with early stage symptoms have to suffer. More than 70 MPs from all parties signed an early day motion condemning NICE’s decision as unethical as well as illogical. Despite this, and the condemnation from national and international medical bodies, there is little hope that NICE is going to change its mind. This will cause gross inequalities of care and treatment for patients: the best care will be available to private patients, but not to those treated by the NHS. The NICE recommendations, unless amended, will deprive patients of treatment at the stage when it would be likely to be most effective and would most improve the patient’s social and family life. The people who will now be denied treatment will already have lost intellectual flexibility; they will be depressed, easily agitated when called upon to organise the simplest tasks, forgetful, confused, moody and will be upset and frustrated by their difficulties in fitting in to society and relating to their families. It is at this stage, when people with Alzheimer’s are still capable of interacting, that treatment can have the greatest impact on the last years of many citizens. The other group who will be denied treatment are those with advanced Alzheimer’s. There is a drug, Ebixa (memantine), that may help these tragic cases. Ebixa belongs to a different group of drugs but has been shown in numerous studies to be effective in some instances for easing the life of those with severe problems. These patients may still be helped by Ebixa even though they are constantly restless, unable to maintain their own personal hygiene, and have difficulties in understanding or even recognising those around them. If the recommendations are not re-drafted they will deny the most seriously disturbed dementia patients the opportunity to try the one drug that offers them and their families any hope. Copyright ©