SCOTLAND has a “golden opportunity” to lead the way in dementia care if the NHS is given the go-ahead to use a new kind of treatment.
That’s the prediction of Henry Simmons, chief executive of Alzheimer Scotland who is worried that the Scottish Medicines Consortium (SMC) will follow the “devastating” decision to block the NHS from using the first of the new drugs in England and Wales.
Simmons told the Sunday National that the new drug, lecanemab, could change the lives of people with Alzheimer’s disease because it is the first medication that has been shown to slow down the progression of any type of dementia rather than just treat the symptoms.
The UK’s Medicines and Healthcare Products Regulatory Agency (MHRA) has approved the use of lecanemab but the National Institute of Health and Care Excellence (NICE) has ruled it should not be used by the NHS in England and Wales.
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In Scotland, a decision has yet to be made by the SMC on whether it will recommend the drug for use in the NHS.
Simmons said NICE’s decision was “devastating” and made it seem like people with dementia were again being “pushed to the back of the queue” when it comes to NHS spending, as only those who could afford to pay the estimated annual cost of £20,000 to buy the drug privately would benefit from the new treatment.
“Even a one-year delay in a person being admitted to residential care could save as much as £80,000 a year,” he pointed out. “It is an omission by NICE not to consider these potentially significant cost savings in their decision-making.”
Simmons, left, believes that instead of considering the value of the new treatment in delaying the disease, NICE was put off by the lack of diagnostic facilities and assessment centres for Alzheimer’s that are necessary to deliver the drug safely.
However, that is no reason to block its use, according to Simmons.
“There is a level of discrimination towards older people at risk of dementia because of the lack of facilities that are in place at the current time,” he said.
“Very few people get access to a brain scan and that is a failing. What other brain disease would not automatically have a brain scan? None in our view.”
Simmons added: “NICE is saying that to deliver the drug safely, you need to fix all the other problems and this would cost a lot of money.
“We are not saying this is a wonder drug and everyone should get it. What we are saying is these types of treatments need a fair assessment in what they are able to do as a drug.
“They shouldn’t be assessed on the lack of progress in our system to enable them to be prescribed.”
While Scotland is not perfect, Simmons said some of the structures necessary to deliver the new drug and others like it are already in place. There is also a strong basis of post-diagnostic support.
“It’s not consistent and about 60% of what we really need, but it is better than nothing,” he said. “We have got a good platform already to build on and I think there is an argument to say that if these drugs do become available we can then maximise a much more holistic approach to support people alongside these treatments.”
Simmons said it was likely that lecanemab was the first of other, similar treatments so it was important to begin work on rolling them out.
“If we don’t start to build a system – even in a small way – to use these treatments, we are just going to miss the whole opportunity,” he said.
The new drug will not be suitable for everyone so it would be possible to start small scale and build up, Simmons pointed out.
“We can start working with what we have and build a change programme within our NHS to get ready to accept some of the new treatments when they come,” he said.
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“This is a golden opportunity for Scotland to lead the way in dementia care and to realise the life-changing potential of lecanemab and any new dementia drug that may follow.
“We urge the SMC to consider the wider benefits this new drug could bring in terms of overall social care costs and for individuals
and families.”
The SMC has not yet announced a date for its decision on the drug.
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