§ Mr. BaronTo ask the Secretary of State for Health (1) how much the NHS spent on anticholinesterase inhibitors for people with Alzheimer's disease in each year since 1997; [144843]
(2) what steps are being taken to ensure that people in long-term care with Alzheimer's disease are assessed for use of anticholinesterase inhibitors; [144844]
(3) what plans he has to re-issue guidance to trusts to ensure that local decisions about whether to prescribe Ebixa on the NHS for people with moderate to severe Alzheimer's disease are not postponed in the absence of guidance from the National Institute for Clinical Excellence. [144845]
387W
Dr. Ladvman[holding answer 18 December 2003]The number of prescription items dispensed in the community for drugs for dementia and the associated net ingredient cost, for each year since 1997, are shown
Number of prescription items and the associated net ingredient cost for drugs for dementia, dispensed in the community in England, 1997 to September 2003 Drugs for dementia April to December 1997 1998 1999 2000 2001 2002 January to September 2003 Net ingredient cost (£000) BNF chemical name Donepezil Hydrochloride 656.8 1,919.2 2,917.4 4,178.2 8,815.3 16,078.3 16,829.7 Galantamine — — — 13.6 880.2 2,469.9 2,834.8 Memantine Hydrochloride — — — — — 21.1 392.9 Rivastigmine — 29.2 297.0 681.0 1,309.2 1,997.9 2,262.3 All drugs for dementia 656.8 1,948.4 3,214.4 4,872.8 11,004.6 20,567.1 22,319.8 Number of prescription items (Thousand) Donepezil Hydrochloride 7.2 20.2 30.4 43.6 91.2 169.3 181.3 Galantamine — — — 0.2 11.3 31.1 36.2 Memantine Hydrochloride — — — — — 0.3 4.7 Rivastigmine 0.4 4.2 9.9 19.7 30.5 32.3 All drugs for dementia 7.2 20.7 34.6 53.8 122.1 231.3 254.5 Notes:
1.The prescription information was obtained from the Prescription Cost Analysis (PCA) system and is based on a full analysis of all prescriptions dispensed in the community, i.e. by community pharmacists and appliance contractors, dispensing doctors, and prescriptions submitted by prescribing doctors for items personally administered in England. Total prescriptions include not only prescriptions originating from general medical practitioners in England but also from hospital doctors, nurses, and dentists, provided they were dispensed in the community. Also included are prescriptions written in Wales, Scotland, Northern Ireland and the Isle of Man but dispensed in England. The data do not cover drugs dispensed in hospital or private prescriptions.
2.Drugs for dementia are those defined in the British National Formulary (BNF) section 4.11.
3.The Net Ingredient Cost refers to the cost (which the dispenser is reimbursed) of the drug before discounts and does not include any dispensing costs or fees. It does not include any adjustment for income obtained where a prescription charge is paid at the time the prescription is dispensed, or where the patient has purchased a pre-payment certificate.
People in long-term care with Alzheimer's disease have the same access to drugs for dementia as people living elsewhere. If appropriate, those involved in their care will refer them as necessary for assessment by specialist mental health teams.
In August 1999 the Department issued Health Service Circular 1999/176 which asks national health service bodies to continue with local arrangements for the managed introduction of new technologies where guidance from the National Institute for Clinical Excellence (NICE) is not available. These arrangements should involve an assessment of all the available evidence. Funding for treatments, such as Ebixa, should not be withheld simply because of an absence of guidance from NICE.