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To condemn NICE as ageist when it limits access to donepezil is to
fall for the vendor's advertising and sponsored trials.
There is really no evidence that donepezil does anyone any good. Have
a look at AD2000 in Lancet or Howard RJ et al in the N Engl J Med. 2007
357:1382-92. These are two proper randomized clinical trials that are not
sponsored by the vendors; both show there is no benefit whatsoever to this
drug.
In particular, neither carers nor patients can tell any difference
between donepezil and placebo.
The tremendous wall of vendor-sponsored RCTs has created a terrible
false impression about these drugs, and desperate families seek desperate
remedies.
"Prescribing drugs according to cost effectiveness may be the
opposite of the rights based approach: decisions can condemn patients to
deteriorate before the drug will be prescribed, as is the case with
Aricept [donepezil] for dementia patients."
The main thrust of the above statement suggest that cholinesterase
inhibitors reverses the underlying pathophysiology of reduced cerebral
production of choline acetyl transferase, of which it does not.
Statements like "condemn patients to deteriorate before the drug will
be prescribed" would only serve to mis-inform the public at large and
heath-professionals in particular.
Omitting donepezil is hardly a hardship
To condemn NICE as ageist when it limits access to donepezil is to
fall for the vendor's advertising and sponsored trials.
There is really no evidence that donepezil does anyone any good. Have
a look at AD2000 in Lancet or Howard RJ et al in the N Engl J Med. 2007
357:1382-92. These are two proper randomized clinical trials that are not
sponsored by the vendors; both show there is no benefit whatsoever to this
drug.
In particular, neither carers nor patients can tell any difference
between donepezil and placebo.
The tremendous wall of vendor-sponsored RCTs has created a terrible
false impression about these drugs, and desperate families seek desperate
remedies.
Competing interests:
None declared
Competing interests: No competing interests