Old age psychiatrists join to oppose 'NICE' proposal to withdraw Alzheimer's treatments from NHS
Mar 18, 2005 - 4:02:00 PM
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"We hope that psychiatrists, carers and relatives of people with AD will make their views known to NICE and to their MPs, so that the conclusions of this draft guidance are changed to enable patients with AD to continue to benefit from the drugs currently prescribed under the NHS"
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By Royal College of Psychiatrists, UK,
[RxPG] The Royal College of Psychiatrists' Faculty of Old Age Psychiatry, with more than 1,800 members across the country, has drawn up a new Resolution which says that denying people with Alzheimer's disease (AD) access to the drugs used to treat the condition will have a detrimental effect on their health and life.
On March 1st 2005 the National Institute of Clinical Excellence (NICE) published their Appraisal Consultation Document, which concluded that the drugs currently used to treat mild to moderate AD (cholinesterase inhibitors) are not cost-effective and should not therefore be available on the NHS.
The unanimously agreed Resolution from the Faculty of Old Age Psychiatry strongly disagrees with the assumptions and methodology of the health economic analysis that led NICE to these conclusions.
'The Faculty's opinion is that denying people with AD access to these drugs will have a detrimental effect on the health and lives of patients and their carers, and on services as a whole," the Resolution states.
A letter sent to Faculty members urges them to draw to NICE's attention a number of weaknesses in their analysis of the data, including the facts that:
* traditional ways of measuring quality of life are not valid in AD
* NICE's previous (2001) appraisal of these drugs accepted problems with the use of quality of life measures in AD
* the economic modelling used in NICE's analysis is not realistic i.e. not based on the use of the drugs in clinical practice
* the guidance ignores, or totally underestimates, the wider societal implications that NICE is obliged to take into account
* alternative treatments (e.g. antipsychotics drugs) will actively do harm.
In addition to responding to NICE, Faculty members will be writing to their MPs.
Prof. Susan Benbow, Chair of the Faculty of Old Age Psychiatry, commented, 'We are all very concerned by the implications for our patients of this new advice. In this consultation paper NICE seems to have adopted an inconsistent and contradictory approach that bears little resemblance to the guidance they issued in 2001.
'NICE agrees that the drugs currently used to treat AD are clinically effective. But the evidence on which they conclude that cholinesterase inhibitors are not cost effective is, we strongly believe, flawed.
'We hope that psychiatrists, carers and relatives of people with AD will make their views known to NICE and to their MPs, so that the conclusions of this draft guidance are changed to enable patients with AD to continue to benefit from the drugs currently prescribed under the NHS."
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Additional information about the news article
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The following resolution was passed at the Faculty of Old Age Psychiatry Conference on 4th March 2005.
RESOLUTION
* The Faculty of Old Age Psychiatry welcomes the conclusions of NICE in its Appraisal Consultation Document that the cholinesterase inhibitors are clinically effective for people with Alzheimer's Disease.
* However the Faculty disagrees with the assumptions and methodology of the health economic analysis that has led NICE to conclude that these drugs are not cost effective.
* The Faculty's opinion is that denying people with AD access to these drugs will have a detrimental effect on the health and lives of patients and their carers, and on services as a whole.
9th March 2004
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