IN BRIEF

ALZHEIMER's drugs no longer reimbursed in France

As of August 2018, the cholinesterase inhibitors donepezil (ARICEPT, generics), galantamine (REMINYL, generics) and rivastigmine (EXELON, generics) and the NMDA receptor antagonist memantine (AXURA, EBIXA, generics) available to treat ALZHEIMER's disease can no longer be prescribed for reimbursement by the statutory health insurance in France (1). The background to this is a recommendation by the French Haute Autorité de Santé (HAS; similar to NICE in Britain), which found that the drugs did not prove a benefit for significant end points such as quality of life or disease progression in a re-evaluation carried out at the end of 2016. Instead, an at best moderate effect of questionable clinical relevance is opposed by significant adverse effects and interactions (a-t 2017; 48: 14-5). In a treatment guideline for patients with ALZHEIMER's disease published by HAS in May, the focus was therefore on non-drug measures such as physical and psychosocial activation, checking hearing and vision and close support of caring relatives (2). We have also not seen any indication for the drugs for years either (e.g. a-t 2012; 43: 54-5), -Ed.

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