New Alzheimer’s treatments that slow the progression of the disease could potentially ease the financial strain on families, according to evidence presented to the National Institute for Health and Care Excellence (Nice). Charities and pharmaceutical companies argue that current assessments of these drugs undervalue their impact on carers and social care costs.
Recent analysis by the Alzheimer’s Society highlights the escalating costs associated with dementia care. Annual expenses increase from approximately £28,700 for individuals with mild dementia to nearly £81,000 for those with severe symptoms. The majority of these costs—around 50 percent—are attributed to unpaid caring provided by family members, while about 40 percent stem from social care, much of which is also funded privately by families.
This issue has risen to political prominence amid efforts by Andy Burnham, the mayor of Greater Manchester, who has accelerated a government review of social care led by Baroness Casey. Burnham, whose father suffers from advanced Alzheimer’s disease, has pledged to use his influence to establish a National Care Service aimed at alleviating the financial burden on families.
In 2024, the UK became the first European country to approve drugs shown to slow Alzheimer’s disease progression. Clinical trials of donanemab, produced by Lilly, demonstrated a 35 percent reduction in cognitive decline with monthly infusions, while Eisai’s lecanemab showed a 27 percent reduction with fortnightly treatments. Nice estimates that these drugs delay the progression of the disease by four to seven months.
Despite these findings, Nice has determined that the drugs do not represent good value for routine NHS use. Manufacturers contest this conclusion, arguing that the evaluation does not sufficiently capture broader benefits, such as reduced caregiving demands and social care costs. Both Lilly and Eisai have entered negotiations with the NHS to agree on pricing that might enable wider access to the treatments.
Chris Stokes, general manager of Lilly UK and Ireland, emphasised that current assessment models fail to reflect the full economic and health burden of Alzheimer’s disease, including the impact on carers, social care, NHS resources, and employment. Evidence cited indicates that more than 112,000 working-age carers have left jobs due to caregiving duties, while an additional 147,000 have reduced their working hours.
The Alzheimer’s Society underlined that extending time spent in earlier stages of dementia or shortening the duration requiring complex care could reduce overall societal costs.
A spokesman for Nice acknowledged the ongoing debate regarding how thoroughly the health technology assessment captures the burden of dementia and its effects on unpaid carers. He noted that these issues were revisited by Nice’s independent appraisal committee and NHS England, and that discussions with the drug manufacturers would continue in pursuit of an outcome beneficial for both patients and the NHS.