Second Alzheimer’s drug, donanemab, not available on NHS

A new Alzheimer’s drug, donanemab, can now be prescribed in Great Britain after getting the green light from the Medicines and Healthcare products Regulatory Agency (MHRA).

In trials, the drug helped slow memory and thinking problems by about a third in people in the early stages of Alzheimer’s, over 18 months.

But the National Institute for Health and Care Excellence (NICE) has decided not to offer donanemab on the NHS, citing its “significant cost”. This includes monthly infusions in hospital and intensive monitoring for side effects, set against its modest benefits for people.

A spokesperson from NICE said the cost-effectiveness estimate for donanemab is 5 to 6 times above what NICE normally considers an acceptable use of NHS resources.

This means that anyone eligible for the drug and who wishes to receive it will have to pay for it privately. NICE will make a final decision in 2025, after collecting further evidence from the public.

• Find out more about donanemab, including how it works and who it’s for, in our explainer. 

Alzheimer’s Research UK’s Chief Executive, Hilary Evans-Newton, described the news as “another frustrating setback” after a similar drug, lecanemab, was turned down in August.

Estimates suggest around 70,000 people in England would have been eligible to receive donanemab.

Evans-Newton called for government leadership, noting that despite the charity’s efforts, they have yet to hear from Health Secretary Wes Streeting on plans to fulfil the Party’s manifesto pledge to transform dementia treatment.

“We’ve written to the Health Secretary again, calling for his leadership to bring together NICE, NHS England and industry so that people with dementia in the UK aren’t left behind.” Evans-Newton continued.

 

 

“I feel as normal as a 78-year-old can be”

Peter Almond is one of only a few dozen people in the UK who received donanemab as part of a clinical trial. Peter, who is living with mild cognitive impairment (MCI), travelled 17 miles from his home in Esher, Surrey, to a clinic in Guildford for treatment every four weeks.

MCI describes memory and thinking problems that are mild but still noticeable. Not all cases of MCI lead to dementia, but it can be the early stages of a disease like Alzheimer’s.

   

He says the drug has enabled him to keep at the same level of functioning as when he started on the trial three years ago. He even completed the London to Brighton Bike Ride in June to raise money for Alzheimer’s Research UK.

“As of now I feel as normal as a 78-year-old can be. I can read, write, think, plan, walk, drive and even run. But I don’t know what will happen in the future.”

Peter stopped receiving donanemab when the trial ended in September, and is now disappointed the drug will not be available on the NHS.

“I understand why NICE is unable to accept the drug because of the cost involved. But the government pays many millions of pounds to support people in the latter stages of Alzheimer’s and the care home sector needs much more income from the State,” he said.

Dementia remains the UK’s leading cause of death, and without action, experts warn that an ageing population means more families will be affected, driving up NHS costs through emergency admissions and care.

“A crucial opportunity”

NHS England says a dedicated team was looking at nearly 30 other Alzheimer’s drugs currently in advanced trials that could be available by 2030. Evans-Newton argued that this means the government and NHS have a “crucial opportunity” to transform how dementia is treated in the future and enable more people to access potentially life-changing medicines.

In recent weeks, experts have called for more new medicines to be made available on the NHS because this attracts more clinical trials and investment to the UK.

Although the UK has a strong history in dementia research, it currently hosts just 7% of global dementia trials and under 3% of participants in phase 3 trials for dementia worldwide live here.

“How the government tackles these challenges will show if they’re serious about bringing innovation to the NHS and cutting the red tape that is limiting people’s access to research and innovative medicines,” said Evans-Newton.

• If you have questions about donanemab, want to know more about dementia research or about how you and your loved ones can get involved in studies, our Dementia Research Infoline can help. You can call us on 0300 111 5 111 (9.00-5.00pm Monday to Friday – excluding bank holidays) or email infoline@alzheimersresearchuk.org.