ABSTRACT
At the beginning of March 2005 the National Institute for Clinical Excellence (NICE) published an appraisal consultation document concerning the use in the National Health Service in England and Wales (NHS) of the four drugs that are registered for the treatment of Alzheimer's disease (AD). This chapter reviews the evidence concerning the effectiveness and cost-effectiveness of the drugs, and the preliminary conclusions of the Appraisal Committee. Given that NICE recommendations very strongly influence what NHS organisations do, the effect of the implementation of the recommendations will be that very few patients will be prescribed these drugs in the NHS in the future. If the drugs are outside the range, they are just outside the range, and NICE has previously recommended the use of treatments that are even more outside the range. This clearly raises significant problems of consistency in NICE recommendations, if the preliminary recommendations become final.
