NHS fights expensive Alzheimer's drugs

If Britain's National Health Service wants to keep expensive remedies out of the hands of early-stage Alzheimer's patients, it's well within its rights, a British court ruled Friday. It's the latest round in a wrangle over drugs that fight the debilitating neurological disease, with patients, their advocates, and drug companies on one side and government bean-counters on the other. The U.K. has a National Institute for Health and Clinical Excellence--known as NICE, in a bit of acronymic irony--that performs cost-benefit analysis of drugs, and often chooses to restrict access to them.

Pfizer and Eisai, co-marketers of the Alzheimer's drug Aricept, have been wrestling with NICE ever since 2005, when the agency quashed the drug completely. Eventually the agency relented, saying the drug could be used in patients with "moderate" cases of the disease. Early-stage patients are out of luck--and, after today's decision, still are. The agency questions the drugs' efficacy, though in some patients the drugs have been shown to halt the disease's progression.

Perhaps most galling to the drug makers is the fact that NICE hasn't shared its cost-benefit math. Lobbying is tough when the opposition's rationale is in a black box. Eisai pledges to keep up the pressure to release that info, but until then, Aricept appears to be down for the count.

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