UCL Queen Square Institute of Neurology


Preparing the NHS for challenges that will result from treatments becoming available for dementia

21 March 2018

A report published today (21 March), by Alzheimer’s Research UK, working with Professor Jonathan Schott, Professor of Neurology and Honorary Consultant Neurologist at the Dementia Research Centre at UCL (UCL Institute of Neurology) and academics from the London School of Economics, evaluates the readiness of the NHS for the financial and practical challenges that will be required as and when a treatment for Alzheimer’s disease and other forms of dementia is found. While there are currently no treatments that can slow or prevent the diseases that cause dementia of which Alzheimer’s is the commonest cause, this report highlights that the UK health system will need to think differently to be able to cope with the unique challenges that will follow when a drug is proven to be beneficial.

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, with many more in earlier phases of development. Against a backdrop of progress in dementia research, the researchers worked 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 with input from industry.

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.

The modelling also highlights that earlier and more accurate 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 has announced it will be leading a 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.

Professor Schott says:

With the huge amount of work that is taking place in dementia research and the advances that have been made in recent years, it is a question of “when”, not “if” new treatments become available. We need to put changes in place now to make sure that we are ready for the cost and infrastructure challenges that this will present, in order to make sure that we do not fall behind in delivering new therapies to our patients.