Leading dementia charity calls for new approach to avoid delaying future treatments in NHS
By Philip Tubby | Wednesday 21 March 2018
New analysis from Alzheimer’s Research UK shows the UK health system will need to think differently to cope with the unique challenges presented by future dementia treatments.
In a report published today, the UK’s leading dementia research charity reveals that the NHS could face significant practical and financial challenges in delivering future treatments. To coincide with its annual Research Conference in London, the charity has announced it will be leading the Dementia Access Taskforce, setting out a series of recommendations to address these challenges. It is calling on government, the NHS and the pharmaceutical industry to join the taskforce to ensure people with dementia can access future dementia treatments without unnecessary delay.
Currently there are 12 potentially disease-modifying treatments for Alzheimer’s, the most common cause of dementia, in the final stages of clinical trials in people. Against a backdrop of progress in dementia research, Alzheimer’s Research UK worked with the London School of Economics to model the impact that five potential future treatments approaches for Alzheimer’s could have on the health system. The analysis was based on ongoing research and guided by an expert clinical panel.
The modelling found that because of the sheer number of people living with dementia, delivering future treatments is likely to pose a significant practical and financial challenge to the current health system. For example, even at a price point that would be considered cost-effective by the National Institute for Health and Care Excellence (NICE), the annual overall cost to the NHS of one of the hypothetical treatments is £420m – a third of the total cost of all cardiovascular medicines.
The analysis also revealed that current approaches to assess the cost-effectiveness of potential new dementia treatments are unlikely to include the full value of new dementia treatments. Dementia costs the UK economy £26bn annually, with over 80% of this cost carried by social and informal care. However, the current approach to evaluate the cost-effectiveness of treatments does not take the full savings in those areas into account.
In addition, the modelling demonstrates that earlier diagnosis will be vital to ensure future treatments can be effectively delivered to the right people at the right time. Although diagnosis today takes place after symptoms begin to appear, the diseases that cause dementia can begin 15 to 20 years before then. The findings back up previous calls for earlier diagnosis, showing that treating earlier would results in fewer people living with dementia, and those with the condition would live with mild symptoms for longer, spending more years with a higher quality of life.
Alzheimer’s Research UK believes the Dementia Access Taskforce presents an opportunity to work collaboratively to pave the way for the smooth delivery of future dementia treatments in the NHS. Based on analysis of the modelling, the charity is making eight recommendations for the taskforce to take forward as initial actions, including:
- Considering innovative funding models to help cover the cost of future treatments.
- Piloting specialist Brain Health Clinics.
- Working to understand what measures will reflect the true value of Alzheimer’s treatments for individuals and society.
Hilary Evans, Chief Executive of Alzheimer’s Research UK, said,
“With over 1 million people expected to be living with dementia in the UK by 2025, we have a duty to ensure that people with dementia and their families can benefit from innovations in new treatments in the coming years. While our report highlights a number of challenges that could affect the roll-out of future dementia treatments in the NHS, we believe these challenges can be overcome if we act now and work together.
“Research happening today will bring about the treatments of tomorrow and over 650 researchers from across the globe are in London this week discussing the positive progress being made. Right now, there is a window of opportunity to develop an action plan to ensure the health system is able to pay for and deliver future dementia treatments, and to ensure they would reach people with dementia without unnecessary delay.”
Dr David Reynolds, Chief Scientific Officer at Alzheimer’s Research UK, said:
“The aim of the report is not to raise hopes today about treatment scenarios that may be some way off, but to gain insight into the factors we need to consider as research makes progress. The main focus of this work is a treatment that would be given in the mild stages of Alzheimer’s, an approach most likely to come through in the next few years.
“While one treatment option in the report modelled the potential cost of a preventative treatment that could be given to over 29 million people to delay the start of Alzheimer’s, we know this is the most speculative treatment scenario of those modelled. Our focus in preparing today needs to be on the treatment approaches most likely to succeed in the next five years.
“Right now, there are 12 drugs in the final stages of clinical trials meaning the first life-changing treatment could be possible within three years, and we know that because of the sheer number of people with dementia, the health system could face significant financial and practical challenges to get a new treatment to people quickly. That’s why we’re launching a taskforce today to begin developing creative and collaborative solutions to these challenges.”
Care Minister Caroline Dinenage said:
“This report shows the scale of the challenge dementia presents not only to individuals and their families, but to wider society – something this government has never shied away from. From the Prime Minister’s Dementia Challenge, to the additional £40m funding for the UK Dementia Research Institute we announced just last week, we are determined to lead the world in tackling this disease.
“I’m pleased that Alzheimer’s Research UK’s taskforce will be considering how to translate the prospect of a life-changing treatment into a reality, to ensure that when we do reach that breakthrough moment in science we are properly prepared.”
An estimated 850,000 people in the UK are living with dementia today. Dementia became the leading cause of death for both men and women across the UK in 2017, pushing heart disease out of the top spot for the first time.
To read the report, “Thinking Differently: preparing today to implement future dementia treatments”, in its entirety, please go to alzheimersresearchuk.org/thinkingdifferently