After decades of slow progress, we finally have a new drug available that could change the lives of people with Alzheimer’s disease.

Never before has there been a medication capable of slowing down or stopping the progression of any type of dementia. Until now.

Previously, drug treatments could only treat the symptoms of Alzheimer’s disease, but the UK’s Medicines and Healthcare Products Regulatory Agency (MHRA) has now approved a new disease-modifying drug called lecanemab.

Alzheimer Scotland warmly welcomes this move and we hope that this is the first of many new treatments of this nature.

But we are devastated by the interim decision made by the National Institute of Health and Care Excellence (NICE) which means that, as it stands, people in the early stages of the disease will not be able to access lecanemab on the NHS in England and Wales.

Unless this position changes, only those who can afford to pay the estimated annual cost of £20,000 to buy lecanemab privately will benefit from this treatment.

Yet again it seems like people with dementia are being pushed to the back of the queue when it comes to NHS spending.

In Scotland, a decision has yet to be made by the Scottish Medicines Consortium on whether it will recommend lecanemab for NHS use.

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 drugs 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.

Lecanemab has shown to be effective at slowing the progression of Alzheimer’s Disease by 27% amongst those at an early stage of their illness, with some trial data suggesting it may slow the rate of disease progression by two-and-a-half to three years.

Even a one-year delay or reduction in a person being admitted to residential care could save as much as £80,000 a year. Imagine the impact that could have on health service budgets and the enormous relief it would bring to people with dementia and their families, many of whom have to pay for this care out of their own pocket.

We believe it is an omission by NICE not to consider these potentially significant cost savings in their decision making.

We also believe it is unfair and unreasonable for a regulator to block broader access to this drug simply due to the NHS’s lack of preparedness.

It is undeniable that there is much work to be done to put in place the systems and infrastructure that would be needed to successfully roll out this drug and to get it into the hands of the people who could benefit from it.

But this work can – and must – be done. After 30 years of waiting, now is the time to be bold and for Scotland’s leaders to do everything necessary to make this happen.

It has been quite clear for many years now what the NHS needs to do in order to be ready for these new disease modifying treatments.

The fact that there has been very little investment in ensuring our system is ready for these new drugs should not be part of either the SMC’s or NICE’s assessment process. It should be highlighted as a failing on the part of the NHS, and the regulator should be recommending and reinforcing what is required by the NHS in order to deliver these treatments.

 

This might be the first treatment of this nature to be assessed, but there will be others and the same problems will exist within our health system unless the NHS makes additional investment. If this continues to be part of the assessment process, then regulators would simply be upholding the serious neglect and unfair treatment of people at risk or living with dementia.

If a new cancer treatment required the basic building blocks of our current system to be costed into an assessment, we doubt if that would be deemed cost effective.

The infrastructure changes and costs required within the NHS need to be assessed in a different way for vital progress to ever be made.

We believe that it is a reasonable expectation, having worked with the Scottish Government and NHS Grampian to set up a Brain Health Clinic in Aberdeen, to prepare for a new world of dementia prevention and treatment. We also know it is possible.

This is a first step in a new dawn for Alzheimer’s disease treatments. We must take this step forward and not hold back in anyway.

Henry Simmons is Chief Executive of Alzheimer Scotland