Patients living with Alzheimer’s disease and dementia-related conditions in England continue to face restrictions in access to two emerging treatments amid ongoing evaluations by health authorities. The National Institute for Health and Care Excellence (Nice) is reassessing evidence for the drugs lecanemab and donanemab, which have been described by campaigners and patients as potential breakthroughs capable of slowing cognitive decline.

Both drugs were initially rejected by Nice in 2024, primarily due to concerns over their high cost relative to the clinical benefit offered. The manufacturer, Lilly, successfully appealed the decision, prompting a renewed review process. If approved for NHS use, these treatments—administered intravenously and targeting the buildup of amyloid protein in the brain—could potentially benefit around 70,000 patients in the early stages of Alzheimer’s in England.

Clinical data indicate that lecanemab may slow memory decline by up to 27% over an 18-month period. However, the treatments are associated with serious side effects, including brain swelling and bleeding, which factor into the cautious approach taken by regulators. Privately, the therapies are available but come at a cost of approximately £60,000 per year, placing them out of reach for many patients.

Advocacy groups and individuals affected by dementia have expressed frustration with the delay in NHS availability, arguing that the UK is falling behind other countries that are already providing such treatments with public or state-supported funding. Michelle Dyson, chief executive of the Alzheimer’s Society, highlighted the urgency for new therapeutic options that could extend the quality time patients have with their families before symptoms advance.

Fran Murt, a 70-year-old former nurse from Liverpool living with Alzheimer’s and vascular dementia, emphasized the need for treatment choices akin to those available in other medical conditions. She noted that while some patients can afford private options, many others cannot, leading to a disparity in care.

In a letter addressed to Health Secretary Yvette Cooper, dementia experts called for a broader consultation beyond the limited clinical perspectives reportedly informing NHS England’s position. They urged Nice to reconsider its stance and facilitate access to these drugs on the NHS, underscoring the growing prevalence of dementia and the potential impact of the treatments.

Responding to these calls, Helen Knight, director of medicines evaluation at Nice, reiterated the committee’s assessment that the modest benefits observed in clinical trials combined with the substantial resource implications for the NHS present challenges. She noted that approving such treatments might necessitate reallocating funds away from other essential services, potentially impacting overall patient care.

As evaluations continue, the debate underscores the complex considerations involved in balancing innovation, cost, patient need, and healthcare system sustainability in the management of Alzheimer’s disease in England.