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To ask the Secretary of State for Health what assessment has been made of the (a) safety and (b) efficacy of memantine for use with moderately severe to severe Alzheimer's disease patients; and if she will make a statement.

Asked by

Howard Stoate (Labour)

Answering body

Department of Health

Type

Written questions

Status

Answered

Date

2 March 2006

Reference

443 c901W;443 c901W; 51627

House

House of Commons

Ebixa

To ask the Secretary of State for Health how many people were prescribed Ebixa on the NHS in West Lancashire in each of the last three years for which figures are available; and what the cost to the NHS was in each year.

Asked by

Rosie Cooper (Labour)

Answering body

Department of Health

Type

Written questions

Status

Answered

Date

27 February 2006

Reference

443 c437-8W;443 c437-8W; 51110

House

House of Commons

Ebixa

To ask the Secretary of State for Health (1) how many people were prescribed Ebixa on the NHS in the last three years for which figures are available; and what the cost to the NHS for Ebixa was in each year;

Asked by

Joan Walley (Labour)

Answering body

Department of Health

Type

Written questions

Status

Answered

Tabled on

6 February 2006

For answer on

8 February 2006

Answered on

27 February 2006

The Department does not hold data on the number of people prescribed particular drugs but does hold data on the number of national health service prescriptions dispensed. Therefore, there is no data on the number of people treated with Ebixa. However, prescription cost analysis (PCA) data shows the number of prescriptions dispensed in England for Ebixa were:

	Prescription items dispensed
2002	319
2003	7,624
2004	17,726

The British National Formulary (section 4.11) lists three drugs, Aricept, Exelon and Reminyl as potentially suitable for the management of mild to moderate Alzheimer's disease. Additionally, Ebixa is listed for the management of moderate to severe Alzheimer's disease. The Department does not know what proportion of prescribing for these drugs were for mild, moderate or severe Alzheimer's disease. However, according to the PCA database, the net ingredient cost of drugs for dementia dispensed in the community in England 2004–05 was £44.7 million, 534.5 thousand items. In addition, Intercontinental Marketing Services estimate that the cost of these drugs dispensed in hospitals in England was £11.9 million in 2004–05.As already mentioned, the Department does not hold data on the number of people prescribed particular drugs but does hold data on the number of NHS prescriptions dispensed. Therefore, there is no data on the number of people prescribed anti-cholinesterase drugs. However, PCA data shows the accumulative costs up to the end of September 2005 for England were:

Drug	First prescribed	Value(£ million)	Prescriptions items dispensed
Aricept	1997	115.3	1,300,000
Reminyl	2000	18.7	242,000
Ebixa	1998	3.5	46,600
Exelon	1998	15.0	217,500

Date

27 February 2006

Reference

50206; 443 c436-7W;443 c436-7W

House

House of Commons

Dept of Health

To ask the Secretary of State for Health, how many people he estimates suffer from Alzheimer's disease in (a) Lancashire and (b) Chorley and South Ribble Primary Care Trust; and which PCTs in Lancashire provide treatment with the drug Ebixa.

Asked by

Lindsay Hoyle (Labour)

Answering body

Department of Health

Type

Written questions

Status

Answered

Date

22 February 2005

Reference

215508; 431 c499-500W;431 c495-6W

House

House of Commons

Dept of Health

To ask the Secretary of State for Health, if he will make a statement on the availability, in advance of the outcome of the appraisal by the National Institute for Clinical Excellence, of Ebixa on the NHS for advanced Alzheimer's disease; what guidance he has issued to (a) primary care...

Asked by

Ian Gibson (Labour)

Answering body

Department of Health

Type

Written questions

Status

Answered

Tabled on

2 February 2005

For answer on

21 February 2005

Answered on

21 February 2005

Dr. Gibson: To ask the Secretary of State for Health (1) if he will make a statement on the availability, in advance of the outcome of the appraisal by the National Institute for Clinical Excellence, of Ebixa on the NHS for advanced Alzheimer's disease; [214529] (2) what guidance he has issued to (a) primary care trusts and (b) other funding organisations regarding the availability, in advance of the outcome of the appraisal by the National Institute for Clinical Excellence, of Ebixa on the NHS for advanced Alzheimer's disease; and if he will make a statement; [214530] (3) what representations he has received regarding the availability of Ebixa for advanced Alzheimer's disease; and if he will make a statement. [214531] Ms Rosie Winterton: National Institute for Clinical Excellence (NICE) Appraisal Guidance No. 19, relating to the use of Donepezil, Rivastigmine, and Galantamine for the treatment of patients with mild to moderate Alzheimer's disease, was issued in January 2001. This guidance is currently under review, and the revised version due for publication in July 2005 will include an assessment of Memantine Hydrochloride (Ebixa). I have received a number of representations on the availability of Ebixa since the product received its license. 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 NICE is not published at the time the technology first becomes available in the United Kingdom. These arrangements should involve an assessment of the available evidence.

Date

21 February 2005

Reference

431 c131-2W; 214529;214530;214531

House

House of Commons

Dept of Health

To ask the Secretary of State for Health, which primary care trusts provide the drug Ebixa for the treatment of Alzheimer's disease.

Asked by

Lord McLoughlin (Conservative)

Answering body

Department of Health

Type

Written questions

Status

Answered

Date

31 January 2005

Reference

210377; 430 c740-1W

House

House of Commons

Dept of Health

To ask the Secretary of State for Health, how much was spent by the NHS on drug treatments for advanced Alzheimer's disease patients in North Southwark and Bermondsey in each year since 1997. - No figures, not publicly available, due to the small number involved.

Asked by

Simon Hughes (Liberal Democrat)

Answering body

Department of Health

Type

Written questions

Status

Answered

Date

26 October 2004

Reference

425 c1189W; 193959

House

House of Commons

Dept of Health

To ask the Secretary of State for Health, if he will list for each (a) primary care trust and (b) strategic health authority area the total amount spent on drugs for severe Alzheimer's disease in the last year for which figures are available; what assessment he has made of the...

Asked by

Howard Stoate (Labour)

Answering body

Department of Health

Type

Written questions

Status

Answered

Tabled on

1 April 2004

For answer on

21 April 2004

Answered on

21 April 2004

Dr. Stoate: To ask the Secretary of State for Health (1) if he will list for each (a) primary care trust and (b) strategic health authority area the total amount spent on drugs for severe Alzheimer's disease in the last year for which figures are available; [166562] (2) what assessment he has made of the availability of drugs for advanced Alzheimer's disease throughout the UK; and if he will make a statement; [166563] (3) what guidelines he has sent to primary care trusts regarding the availability of drug treatments for severe Alzheimer's disease patients; and if he will make a statement; [166564] (4) what discussions he has held with (a) patient groups, (b) charities, (c) old age psychiatrists and (d) the drug industry concerning the availability of drug treatment for severe Alzheimer's disease patients; [166565] (5) if he will make a statement on the funding for drug treatments for severe Alzheimer's disease in advance of a National Institute for Clinical Excellence appraisal; [166566] (6) if he will list the licensed treatments currently available for moderately-severe to severe Alzheimer's disease patients. [166567] Dr. Ladyman: The Medicines and Healthcare products Regulatory Agency (MHRA), on behalf of the Licensing Authority, grants marketing authorisations for medicinal products provided that satisfactory quality, safety and efficacy data have been submitted for the medicinal product for use in the proposed indication and that the risk benefit is deemed favourable. According to the MHRA records, there is one licensed product, Ebixa (memantine hydrochloride), which is indicated for the treatment of moderately-severe to severe Alzheimer's disease. Information on Ebixa dispensed at primary care trust and strategic health authority (SHA) level is not publicly available due to the small numbers involved. However, it is known that Ebixa was dispensed in the community in all 28 SHAs in England in 2002-03. No formal discussions have taken place between Ministers and stakeholders concerning the availability of drug treatment for severe Alzheimer's disease patients. The National Institute of Clinical Excellence (NICE) is, however, appraising Ebixa as part of the eighth wave of its work programme. The anticipated publication date of its guidance is May 2005. The Department has asked National Health Service bodies (in HSC 1999/176) to continue with local arrangements for the managed introduction of new technologies, including drugs such as Ebixa, where guidance from NICE is not published at the time the technology first became available. These arrangements should involve an assessment of all the available evidence. When considering the funding of any treatment currently being appraised by NICE, or where no appraisal has been commissioned, funding authorities are expected to use their existing prescribing arrangements and consider the evidence available to them on the clinical effectiveness of the treatment. When considering the funding of any treatment currently being appraised by NICE, or where no appraisal has been commissioned, funding authorities are expected to use their existing prescribing arrangements and consider the evidence available to them on the clinical effectiveness of the treatment.

Date

21 April 2004

Reference

420 c547-8W; 166562;166563;166564;166565;166566;166567

House

House of Commons

Dept of Health

To ask the Secretary of State for Health, which NHS trusts make the drug Ebixa available for people with dementia on the NHS; and which do not; if he will make it his policy to ensure that Ebixa is available, on prescription, to all people suffering from dementia regardless of...

Asked by

Mike Hancock (Liberal Democrat)

Answering body

Department of Health

Type

Written questions

Status

Answered

Date

22 March 2004

Reference

419 c593W;419 c595W; 162293;162294

House

House of Commons

Dept of Health

To ask the Secretary of State for Health, how much the NHS spent on anticholinesterase inhibitors for people with Alzheimers disease in each year since 1997; what steps are being taken to ensure that people in long-term care with Alzheimers disease are assessed for use of anticholinesterase inhibitors; what plans...

Asked by

John Baron (Conservative)

Answering body

Department of Health

Type

Written questions

Status

Answered

Tabled on

15 December 2003

For answer on

7 January 2004

Answered on

7 January 2004

Mr. Baron: To 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] Dr. Ladyman: [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 in the table. Information is not collected about the number and costs of drugs for dementia dispensed in acute and mental health trusts. 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 1998 1999 2000 2001 2002 January to December 1997 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.

Date

7 January 2004

Reference

416 c386-8W; 144843;144844;144845

House

House of Commons

Dept of Health

To ask the Secretary of State for Health, what assessment he has made of the availability of the anti-dementia drug Ebixa.

Asked by

Paul Burstow (Liberal Democrat)

Answering body

Department of Health

Type

Written questions

Status

Answered

Date

20 November 2003

Reference

140111; 413 c1374W;413 c1370W

House

House of Commons

Dept of Health

To ask the Secretary of State for Health, what progress is being made by the National Institute for Clinical Excellence in appraising the drug Memantine for the treatment of Alzheimer's disease; and if he will make a statement.

Asked by

David Atkinson (Conservative)

Answering body

Department of Health

Type

Written questions

Status

Answered

Date

17 July 2003

Reference

124980; 409 c630W

House

House of Commons

Dept of Health

To ask the Secretary of State for Health, when he will decide whether the drug Memantine should be made available on the NHS to treat Alzheimer's disease; and if he will make a statement.

Asked by

David Atkinson (Conservative)

Answering body

Department of Health

Type

Written questions

Status

Answered

Date

28 April 2003

Reference

106520; 404 c254-5W;404 c254W

House

House of Commons

Hunt of Kings Heath, Lord

Whether they will encourage the National Institute for Clinical Excellence to assess the medical drug Ebixa for use by patients with Alzheimer's disease; and what discussion they have had, or intend to have, with the Alzheimer Society about the use of Ebixa for patients with Alzheimer's disease. [HL 1544] {1545].

Asked by

Lord Ashley of Stoke (Labour)

Type

Written questions

Status

Answered

Date

17 February 2003

Reference

HL 1544; 644 c156WA

House

House of Lords

Hunt of Kings Heath, Lord

Whether the findings of the Committee on Safety of Medicines have encouraged doctors to prescribe the medical drug Ebixa for patients with Alzheimer's disease. [HL 1543].

Asked by

Lord Ashley of Stoke (Labour)

Type

Written questions

Status

Answered

Date

13 February 2003

Reference

HL 1543; 644 c143WA

House

House of Lords

Dept of Health

To ask the Secretary of State for Health, if he will make a statement on the availability to NHS patients of the drug Ebixa for the treatment of Alzheimer's disease; when the National Institute of Clinical Excellence will issue guidance on the use of Ebixa for the NHS in England...

Asked by

Robert Syms (Conservative)

Answering body

Department of Health

Type

Written questions

Status

Answered

Date

11 December 2002

Reference

396 c393W; 85467;85470;85468

House

House of Commons

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Answering member

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