LONDON -- Pharmaceutical companies and Alzheimer's patient advocates went to Britain's High Court on Monday in a bid to force the state-run health service to give all patients access to three drugs to treat the brain-destroying disease.
The case is the latest in a series of legal challenges to Britain's National Health Service, which offers free health care and low-cost medicines to all Britons -- but is regularly accused of rationing access to treatment.
Drug companies Eisai Co. Ltd. and Pfizer Inc., along with the Alzheimer's Society, want to overturn a decision by the government's medicines watchdog not to approve a group of drugs known as acetyl cholinesterase inhibitors for patients in early stages of the disease.
The National Institute for Health and Clinical Excellence (NICE), which regulates use of prescription drugs, recommended last year that three drugs -- donepezil, rivastigmine and galantamine -- not be prescribed for patients with early stage Alzheimer's.
It said the treatment was not particularly effective for people with mild Alzheimer's and at about 2.50 pounds (US$5; euro3.70) per patient per day was not cost effective. It recommended the drugs for patients with moderate-stage Alzheimer's.
What are we to do with the current generation of Alzheimer's drugs? There is relatively little evidence that they make a large physiological difference for most patients. Many patients, family members, and physicians invest so much hope in these pills, in the absence of better tools against this awful disease.
The fact this particular episode is playing out under NHS in Britain reminds us that universal care, even if achieved, will not be infinite, and decisions will have to be made on coverage--certainly at the margins of effectiveness.
Meanwhile, my HMO as a relatively well-covered state employee (or "employe" as Wisconsin would have it--saves buckets of ink by dropping that final "e") does not provide full coverage for several of my highly effective prescription drugs--not on the approved drug formulary for my plan.
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