Alzheimer’s campaigners and charities have urged the government to act after a new “wonder drug” was ruled too expensive for the NHS.
The Medicines and Healthcare products Regulatory Agency (MHRA) has approved lecanemab after clinical trials showed it slowed mental decline by 27 per cent in early Alzheimer’s patients.
However, the National Institute for Health and Care Excellence (Nice) said the benefits are “just too small to justify the significant cost to the NHS” – so the drug will only be available privately.
Alzheimer’s Research UK branded the decision “deeply disappointing” and has urged Wes Streeting to ensure patients are granted access to potentially life-changing treatments.
In a letter seen by The Independent, Hilary Evans-Newton, chief executive of Alzheimer’s Research UK, made a direct plea to the health secretary.
“On behalf of our supporters, Alzheimer’s Research UK are calling on you to help the NHS be fit for the future of dementia. Your leadership in bringing together key stakeholders is needed to help enable fast and equitable access to a new generation of treatments,” Ms Evans said.
“The MHRA licence granted today reflects the great strides made in research over the last 20 years and moves us a step closer to a world free from the harm and heartbreak of dementia. Right now, one in three people in England aren’t receiving a formal diagnosis and there are considerable waiting lists to receive a dementia diagnosis with people waiting up to a year. Action from government is essential to address these challenges.”
Ms Evans said that, despite the NHS ruling, the drug “represents the beginning of a sea change in how diseases like Alzheimer’s will be treated in future”.
According to Nice, an estimated 70,000 patients would have benefited from the new treatment, which costs around £19,000 per patient per year. Just under 1 million people in the UK are living with dementia, and it is the leading cause of death in the country.
Lecanemab, which is given through fortnightly infusions, will be available but through private healthcare, leading to fears of healthcare inequality.
Debbie Abrahams, former chair of the all-party parliamentary group on dementia, told The Independent she was concerned by the announcement.
“Access to treatment should not be dictated by a person’s wealth, yet now only those who can afford it will benefit from this new drug,” she said. “This decision risks undermining the principle of equal access to healthcare in the UK and could have far-reaching consequences for future Alzheimer’s research and medical innovation.”
And Tara Spire-Jones, director of the Centre for Discovery Brain Sciences at the University of Edinburgh, added: “This will see greater inequities emerging in people with dementia, as only those who are able to access private healthcare will be able to receive the drug.”
The drug has been developed by Eisai, a Japanese pharmaceutical company, and is sold under the brand name Leqembi. Trial patients saw their decline in thinking and memory skills slow by 27 per cent. The drug also slowed the decline in quality of life by up to 56 per cent.
Lecanemab has already been approved in the US, Japan and China. But the European Medicines Agency (EMA) rejected lecanemab in late July, saying the benefits were small and did not counterbalance the risk of serious side effects, which can include microbleeds and swelling on the brain.
Larry Woelk, who was diagnosed with mild cognitive impairment in 2018, has been taking part in a trial of the drug since 2020.
“When I first went on the trial my memory was getting worse and worse,” the 77-year-old from Hampshire said. “Not quickly, but I could tell. But since taking lecanemab I feel that the progression of my symptoms has plateaued.”
Mr Woelk’s wife Rita added that her husband has been able to “live a full life” thanks to the drug, and hoped it would help people come forward to get a diagnosis.
The drug is the first treatment of its kind to be licensed for use in the UK, but Nice said the costs involved were prohibitive.
Nice chief executive Dr Samantha Roberts said: “This is a new and emerging field of medicine which will no doubt develop rapidly.
“However, the reality is that the benefits this first treatment provides are just too small to justify the significant cost to the NHS.”
A public consultation on Nice’s draft guidance will close on 20 September.
A Department of Health and Social Care spokesperson said: “It is right that these decisions are taken independently based on an assessment of the available evidence on the relative costs and benefits of a treatment.
“The government is committed to continuing to expand research and innovation in this area, with advanced clinical trials for other drugs underway. We will continue to work with NHS England and Nice to make treatments available as and when they’re ready.”
The health secretary was approached for comment.