Aricept donepezil regulatory update

The U.K.'s NICE issued an appraisal consultation document that would allow for the broadened use of 4 Alzheimer's disease (AD) drugs that were restricted in 2006 guidance. NICE now recommends the use of 3 acetylcholinesterase (AChE) inhibitors for their licensed indication of mild to moderate AD: Aricept donepezil from Eisai and Pfizer; Razadyne (Reminyl) galantamine from Shire and Johnson & Johnson; and Exelon rivastigmine from Novartis. NICE said patients should first receive the AChE inhibitor with the lowest acquisition cost, but could be switched to an alternate AChE inhibitor if considered appropriate based on adverse events, adherence, co-morbidity and drug interactions. The 2006 guidance limited the use of the drugs to patients with moderately severe disease (see BioCentury, June 15, 2009 & Sept. 14, 2009). ...