The Advent of Disease-Modifying Dementia Treatments (DMDTs)

Recent years have seen significant strides in our understanding of dementia, particularly Alzheimer’s disease. These advancements have led to the development of Disease-Modifying Dementia Treatments (DMDTs). These treatments aim to alter the course of disease progression and reduce its severe impact. Currently, the UK has not licensed any DMDTs, but several are undergoing various stages of development and approval. The National Institute for Health and Care Excellence (NICE) will be evaluating new Alzheimer’s treatments, namely, lecanemab and donanemab, next year. 

Preparing for the Evaluating New Alzheimer’s Treatments

In preparation for the evaluation of these innovative treatments, NICE, in collaboration with the NHS and patients, has initiated work to identify potential issues that may arise during planned and future evaluations. This work is being carried out by NICE’s Health Technology Assessment Innovation Laboratory (HTA Lab) and is based on current knowledge, publicly available evidence, and in-depth discussions with researchers, patient groups, and NHS colleagues.

Key Issues to Consider in the Appraisal Process

The report highlights several issues that require attention in a comprehensive appraisal process. One issue is the uncertainty surrounding the number of people with mild cognitive impairment. Another concern is the present need for invasive tests to determine eligibility for new treatments. Lastly, there’s a critical lack of data on the long-term effectiveness of DMDTs currently published. Extensive assumptions will be required to extrapolate results from current research trials to infer the lifetime benefit of DMDTs in terms of quality and length of life.

Economic Modelling Considerations and the Future of Dementia Treatment

Economic modelling considerations also come into play. DMDTs are expected to be administered by intravenous infusions in hospitals, and the economic models will need to include these additional costs. Despite these challenges, NICE’s methods and processes for technology appraisal continue to be suitable for assessing these innovative new treatments.

The development of disease-modifying treatments for dementia represents a long-awaited change in the management of a condition associated with a considerable burden of illness. The UK is at the forefront of this research, and these new treatments represent potentially significant advancements in the field.