Key points from article :
The National Institute of Health and Care Excellence (NICE) has decided not to fund the Alzheimer’s drug donanemab on the NHS in England. This decision is based on the drug’s high cost and relatively small benefits. Donanemab, which works by clearing amyloid, a sticky protein in the brain linked to Alzheimer’s, slows cognitive decline by four to seven months. However, it does not stop or reverse the disease, and patients do not recover; they simply experience a slower progression of symptoms.
While the drug was hailed as a breakthrough when it first emerged, NICE determined that the cost—estimated at £25,000 per year in the US, excluding additional monitoring and care—outweighed its benefits. Monitoring for serious side effects, such as brain swelling, is necessary. Trials showed brain swelling occurred in up to a third of patients, with two confirmed deaths related to this side effect. Due to these risks, genetic testing is required before patients can use the drug, and they must be regularly monitored throughout treatment.
Despite NICE’s decision, donanemab has been approved by the MHRA for private use, meaning patients can access it outside the NHS. Around 70,000 people in England would have been eligible for treatment. While NHS England has no cap on drug costs, NICE evaluates treatments based on their impact and cost-effectiveness. Donanemab was found to be five-to-six times more expensive than what the NHS typically considers reasonable.
NICE's decision aligns with previous rejections of dementia drugs like lecanemab, also deemed too costly. Alzheimer's experts have expressed disappointment, though they remain hopeful about ongoing research. Dementia remains the leading cause of death in the UK, and with an aging population, finding affordable treatments is critical to managing healthcare costs.
