NHS warned on £9bn cost of Alzheimer’s breakthroughs

The UK health system is unprepared for potential breakthroughs in the treatment of Alzheimer’s and other forms of dementia that could cost the National Health Service up to £9bn a year, according to new analysis by researchers at the London School of Economics.

The study, which was commissioned by Alzheimer’s Research UK, concluded 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”.

Dementia became the leading cause of death for both men and women across the UK last year — the first time that another ailment has caused more deaths than heart disease.

While scientists and pharmaceutical companies have so far failed in their attempts to find a treatment, the researchers said 12 “potentially disease-modifying” medicines for Alzheimer’s — the most common cause of dementia — are now in the final stages of human clinical trials.

They estimate that the medicines could range in cost from about £300m to around £9bn a year for the NHS. The estimates also take into account savings to the wider health and social care system from treatments that might delay the onset of the condition, or postpone further decline.

Jonathan Schott, co-author of the study and professor of neurology at University College London, said the availability of new treatments for Alzheimer’s disease “is a ‘when’ not an ‘if’.”

“Our patients are desperate for treatments,” he said. “When we have a successful trial this will be headline news around the world and the demand will be instant and huge.

Our patients are desperate for treatments. When we have a successful trial this will be headline news around the world and the demand will be instant and huge

Jonathan Schott, University College London

“We need to start planning what is needed to offer our patients treatments before they become available if we are going to serve people well.”

Prof Schott drew an analogy to stroke care, where clot-busting drugs were introduced that needed to be given to patients within three hours of having a stroke. But the health system was not initially set up to allow for rapid scans and diagnoses.

“It is partly an issue of forward planning and partly an issue of how we develop the services,” he said.

The LSE analysis also questioned whether the current model for evaluating how much the NHS should pay for drugs is suitable for dementia, where both costs and savings may fall outside of the health service’s purview.

Standard assessments by the National Institute for Health and Care Excellence take some social care costs into account, but do not factor informal care, which is often provided to dementia patients by relatives who may have had to give up their own jobs.

Alzheimer’s Research UK wants the government, as well as the NHS and the pharmaceutical industry, to work with it on a joint task force to consider “innovative funding models to help cover the cost of future treatments” and pilot specialist brain health clinics.

Caroline Dinenage, care minister, said the report showed “the scale of the challenge dementia presents not only to individuals and their families, but to wider society”.

“We are determined to lead the world in tackling this disease,” she added.

Separately, Jeremy Hunt, health and social care secretary, called on Tuesday for “a partnership between the state and individuals” to meet the spiralling costs of social care.

He said in a speech in London that a consultative paper on social care, due in the summer, would look at “how we better ‘risk-pool’ for people with more complex care needs that are disproportionately financially affected, as the prime minister promised in the election campaign”.

Last year’s Conservative manifesto proposed individuals retain only £100,000 in assets, with the rest used to fund care costs whether at home or in a care home. But the proposal backfired spectacularly, forcing Theresa May to promise the government would set a cap on the sums middle class households would have to find to fund social care costs.

Source: https://www.ft.com/content/64ed964c-2ba1-11e8-a34a-7e7563b0b0f4

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