Before dismissing the Alzheimer’s ‘wonder drug’, Wes Streeting must consider the benefits to social care

Editorial: The health secretary should take into account the wider societal benefits when assessing a treatment proven to slow the progression of cognitive decline – but whose price tag is prohibitive for use on the NHS

The Alzheimer’s drug lecanemab has been approved by the MHRA – but not by NICE (PA)

Any new pharmaceutical treatment that appears to work and to be safe is now routinely hailed as a “wonder drug”. We do not yet know whether the term should apply to lecanemab, but it does mark a significant step forward that would be welcomed by many of the estimated 70,000 people in Britain experiencing the early stages of Alzheimer’s disease who might benefit from it.

The Medicines and Healthcare products Regulatory Agency (MHRA) on Thursday approved lecanemab, produced under the brand name Leqembi, as effective and safe to use. It said that the drug slows the progression of cognitive decline by four to six months.

But its ruling was immediately followed by the preliminary decision by the National Institute for Health and Care Excellence (NICE) that “this is just not enough benefit to justify the additional cost to the NHS”, and that the drug will therefore be denied to NHS patients.

The drug is certainly expensive, costing about £19,000 a year, including the cost of administering it intravenously. But The Independent agrees with some of the dementia charities in their argument that NICE’s cost-benefit analysis is too narrow, focusing on the patient and the NHS alone, and overlooking the wider benefits of a treatment that could reduce the need for social care.

At a time when the supply of care workers from abroad is declining, and when the stress on the sector is such that the Joseph Rowntree Foundation predicts that 1 million more people will be providing unpaid care in a decade’s time, the cost to society is great and rising. Anything that could reduce the burden on carers ought to be welcomed – in addition, of course, to the benefits of greater quality of life enjoyed by the old people themselves.

We accept that there is a balance to be struck with any new drug. Not only is lecanemab expensive, but there are risks, which is why it has not been approved for homozygous patients – people who have two copies of the ApoE4 gene – for whom there is a higher risk of swelling or bleeding on the surface of the brain. The European Medicines Agency has so far refused to approve the drug at all, because of these safety fears.

However, the MHRA has followed the US authorities in reaching a different view, and we believe, therefore, that lecanemab ought to be an option on the NHS for patients who make an informed decision that the benefits outweigh the risks.

The good news is that lecanemab is likely to be the first of many similar drugs that may be effective in blocking or delaying the onset or progress of dementia, and that the costs of such drugs are likely to fall as take-up increases.

But in the meantime there are people who could gain from lecanemab now, and for whom a six-month delay in the progression of Alzheimer’s could be priceless. They should not be forced to go private for it. Wes Streeting, the health secretary, should step in to change the remit of NICE, to require it to take into account the wider social costs of denying this useful drug to NHS patients.