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TX: 10.08.07 - Alzheimer's drugs

PRESENTER: LIZ BARCLAY
THE ATTACHED TRANSCRIPT WAS TYPED FROM A RECORDING AND NOT COPIED FROM AN ORIGINAL SCRIPT. BECAUSE OF THE RISK OF MISHEARING AND THE DIFFICULTY IN SOME CASES OF IDENTIFYING INDIVIDUAL SPEAKERS, THE 91热爆 CANNOT VOUCH FOR ITS COMPLETE ACCURACY.


BARCLAY
But first that High Court decision on anti-dementia drugs. Just over an hour ago a judge handed down a partial verdict in this landmark case about who can get anti-dementia drugs, including Aricept, in England, Wales and Northern Ireland. Well our reporter Carolyn Atkinson is at the High Court in London. Carolyn, what do we know so far?

ATKINSON
Well I've just come out and as you say the case is still going on, the judge is still hearing both sides of the argument as to what happens next. But basically there were six points that the judge looked at and out of those six points she has upheld only one of them. Now that relates to people - a group of people - who have learning disabilities or who don't have English as a first language, who she has decided are discriminated against under the current NICE guidance about who gets these dementia drugs or not. And for example that would be people, for example, like people who have Down's Syndrome, now they have a higher risk of getting dementia in the first place and she has decided that the way the current rules operate it would discriminate against them in a particular way. And the reason for that is that at the moment under this guidance you only get these drugs if you are deemed to be moderately ill with Alzheimer's - you get the drugs. Now moderate is decided when do a what's called mini mental test, they do a test and they come up with a score. And anything between 10 and 20 means that you are moderate. If you get under 10 then you move into what's called the severe category and at that point they decide you are severe you can't get the drugs and you are taken off the drugs. Now her concern is that some people with learning disabilities may score under 10 when they do this test and have the drug withdrawn. But she's arguing and agreeing that the score is low - it's under 10 - because of the learning disability, not because of the dementia. So that is her argument and that is the point that she's upheld upon. Now it's still all very much going on and it's still very unclear as to what the final verdict's going to be on this and the argument that's going on at the moment is whether because one of those points have been upheld should the whole set of guidance sort of go back to the drawing board and should the whole of the guidance be quashed and we start all over again?

BARCLAY
So there's still a lot going on as you say but as we heard in the news bulletin people with Alzheimer's and their carers are very angry about all of this. What is it about these drugs that they are so important?

ATKINSON
Well the top sort of fact is that everyone agrees they work, everyone from NICE to the drug companies and the Alzheimer's Society, they agree that drugs, like Aricept, do work in terms of treating cognitive and behavioural symptoms for people with mild to moderate Alzheimer's Disease. And that means things like understanding, communicating with your husband or your wife, the types of behaviour - it can reduce inappropriate behaviour - it can slow down the inevitable progression that this disease will inevitably follow. And so it buys people time. People say it's things like spending more time with their grandchildren, being able to write letters, popping out to buy a paper, you know, getting on the bus on your own, not wandering off and forgetting where you are. All very, very important things which increase the person's quality of life and the quality of the carer and generally there's an awful lot of unpaid carers looking after people with Alzheimer's. I mean at the moment we know that 52,000 people in the UK are taking Aricept. And one of the key factors that has really angered people about this decision that's being discussed in court at the moment is that the decision to restrict this drug to people with only moderate Alzheimer's, i.e. not those with mild symptoms, not the newly diagnosed people, is that it's in fact a reversal of what NICE itself ruled on back in 2001, at that point they said everybody with mild or moderate Alzheimer's could get the drug and that's what's really riled people. This is a very, very groundbreaking case, it's the first time that NICE - the National Institute for Clinical Excellence - has been taken to court over one of its decisions. Now with me is Keith and Lillian Turner. Now Keith you have Alzheimer's - we've spoken to you a lot over the past two or three years on You and Yours, you've been taking Aricept and from your point of view why are you hoping that this verdict will actually be quashed and go back to square one, why is Aricept so important?

KEITH TURNER
Aricept is so important because as I've proven in my case I was put on them in the very early stages of diagnosis which was November 2004. Within a very few months I got my life back again, I was starting to live a normal life, to do the things that a normal person would expect to do - to drive, to go out by themselves, to be able to take decisions for themselves - I can now do all those things. Now the thing is what NICE is saying moderate to later stages you've lost those years, it's got to be prescribed in the early stages to get all the advantages, all the benefits that I have had and still having for three years.

ATKINSON
And Lillian, as Keith's wife why to you do you think it's a fact that the drugs really do work and should be given at an earlier stage?

LILLIAN TURNER
I think it should be given to everybody early because it gives them their life back. Okay it doesn't suit everyone but the greater majority can take them. And I think if they're in the early stages and they're in the younger age group there's a possibility they can go back to work and support themselves.

ATKINSON
Okay Keith and Lillian Turner thank you very much indeed.

Well as we speak the case is still going on. The representatives of NICE are still in the court, the representatives from the drug companies and the Alzheimer's Society are in the court and the judge is still listening. So at the moment no one has decided whether this is just going to sort of get a sticking plaster put over the bit that she's ruled on and said okay sort that bit out everything else stands or whether the whole thing gets quashed and we're back to square one.

BARCLAY
Well Carolyn thank you very much for joining us from the high court and presumably we'll hear more on that as the day goes on. And in response to the high court verdict so far the National Institute for Health and Clinical Excellence - NICE - has issued the following statement:

"The legal challenge to our recommendation that drugs for Alzheimer's Disease should only be prescribed to those in the moderate stage of the disease has failed. We were challenged on six grounds and the court found in our favour in five of them. This ruling strengthens NICE by endorsing our approach to evaluating drugs."

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