Dementia and Alzheimer’s Treatments

Question

Asked by

To ask His Majesty’s Government what steps they are taking to advance the development of dementia and Alzheimer’s treatments.

My Lords, the Government are committed to advancing the development of dementia treatments having invested £496.4 million over the past five years through the National Institute for Health and Care Research and UK Research and Innovation. Additionally, the Dame Barbara Windsor Dementia Goals programme, with up to £150 million of associated funding, aims to speed up the development of new treatments for dementia by accelerating innovation in biomarkers, clinical trials and implementation.

I thank the Minister for that helpful response. Finding a cure for dementia is the challenge of our time. Some drugs now available delay the onset of dementia. They are available privately, but not on the NHS. The NHS says that the assumed costs of administering the drugs are too high. Can the Minister look into this matter to see whether she can clear any barriers to making the new drug lecanemab accessible to everybody on the NHS?

I understand the point the noble Lord is making; I was glad to have the chance of a discussion with him yesterday. I also thank him for his campaigning on such an important matter. I share his view about the need to ensure speed and efficacy. To that point, I say to him that since March this year, as part of the regulation action plan, NICE and the MHRA have been building on the systems we already have in place to make sure that there is rapid access. To prepare for a new generation of dementia treatments, NHS England is working closely with regulators to ensure that arrangements are in place to support the adoption of any new licensed and NICE-recommended treatments as soon as possible. As the noble Lord will understand, it is important that we have the right treatments that do the job and are available. On some of the more recent ones, I understand the disappointment, but the fact is that no disease-modifying treatments are currently available. However, science is developing, and I am sure we will discuss this further.

My Lords, more than 150 treatments are in the Alzheimer’s medicine pipeline. Can I encourage the Minister, along with her ministerial colleagues in the Department of Health and Social Care, to take all steps to ensure that the UK remains globally competitive as a centre for dementia clinical trials?

My noble friend raises a very important point. In terms of trials, I will certainly be signing up—and I encourage noble Lords and their friends and families to do likewise—to Join Dementia Research, which is a collaboration between NIHR and a number of excellent charities, including the Alzheimer’s Society and Alzheimer’s Scotland, to take part in trials. There is no need to be a particular age or to have a diagnosis of dementia. I hope that noble Lords will join me in supporting this endeavour.

My Lords, the commission on palliative care that I am currently involved in has found that by integrating services for patients with dementia, such as in the York Frailty Hub, the number of admissions to hospital can be decreased. People can stay at home with families supported and they can carry on living well within limited capabilities while we wait for new treatments and, hopefully, prevention to come along. Will the Minister meet me and Professor Mike Richards to go through some of the details of our findings? They have huge implications in saving finances for the NHS and improving care of patients.

That is a very helpful offer which I will be pleased to accept. I compliment York on its initiatives, which set a very high standard. I will also discuss the points that the noble Baroness has raised with Minister Kinnock, who is the responsible Minister in this area.

The previous question shows how the rollout and co-ordination of good practice are really important. Therefore, in light of the 50% staffing cuts to NHS England, can the Minister clarify the plan for the national dementia team which sits within NHS England? Will its core funding and capacity be protected or cut?

We are abolishing NHSE. It is the biggest quango, and we are finding immense duplication. At this stage, I cannot comment on the exact matter to do with the team, but I can say that dementia work continues to be a very high priority, as I hope the noble Lord heard from my commitment to the noble Lord, Lord Evans. Indeed, we are keen to support not just those at risk of dementia but those who care for them. This is an expanding area of work. We have much good practice to draw on and we are extremely active, as the noble Lord has heard, in developing research to move further forwards more quickly.

My Lords, I thank my noble friend Lord Evans for raising this issue. We know that, often when a new drug is developed, even though some patients may benefit, it may initially be too expensive for NICE to recommend, based partly on a cost-benefit analysis. We know that eventually the price falls to a level which the NHS can afford and which can then be seen as good value for taxpayers. Given that this happens with many new drugs, have the Government considered convening a group of philanthropists, foundations, charities and other civil society organisations that might be willing to fund treatment for some, if not all, patients when new but expensive breakthrough drugs such as those my noble friend Lord Evans referred to are available but are considered too expensive initially?

We are very open to all sorts of creative ways of dealing with the matter, but it is important to say on the drugs that we are discussing that lecanemab and donanemab can only slow the progression of the disease by between four and six months. The challenge is not just whether it is available on the NHS but how helpful it is. We have a lot of progress to make, and that is why we are committed to ensuring that new treatments can quickly become available and that prevention is key.

My Lords, I have of course signed up for the dementia survey and I recommend it. One of the commonest forms of dementia is vascular dementia and we can do quite a lot to prevent it and treat it when it is caused by high blood pressure and diabetes. It requires quite a bit of surveying the population. How far have we got with that?

I am glad that I will be joining my noble friend in signing up as a volunteer. Certainly, the Lancet commission of last year said that some 45% of dementia cases are estimated to be preventable or delayable. That report is going to inform our actions as we look to the future. Perhaps it is helpful to clarify to your Lordships’ House—I am sure that many of us have experience of this—that the NHS health check for adults in England aged 45 to 74 is designed to do exactly as my noble friend says and identify early signs of various conditions which are contributory factors.

A lot of the challenges in testing the efficacy of some medicines lie in measuring the progression of the disease. That is mainly done verbally and, as we all know, people have good days and other not-so-good days, so measuring the progression and impact of the treatment is hard. As the Minister will be aware, things such as retina scans are showing quite promising measurements in terms of the onset and progression. What are we doing in research in that area?

I will be pleased to write to the noble Lord on that specific point, but it might be helpful if I say on the point raised earlier by the noble Lord, Lord Kamall, that investment in discovery science by the UK Dementia Research Institute, for example, included the recently announced Shingrix study in partnership with GSK and Health Data Research UK, and we are also working via the Dementia Translational Research Collaboration. I am sure that the noble Lord will be aware of the NIHR dementia trials network, which offers people with dementia the opportunity to take part in early clinical trials irrespective of where they live. The summary of all this is that we have some way to go, but we have made considerable progress in investment and plans for the future. I will take into account the noble Lord’s point.