Eli Lilly’s Kisunla (donanemab) will not yet be made available to Alzheimer’s patients in the UK after the National Institute for Health and Care Excellence (NICE) said it doesn’t demonstrate good value for UK’s NHS. On 23 October, the UK’s Medicines and Healthcare products Regulatory Agency (MHRA) granted approval to the therapy for the treatment of mild cognitive impairment or mild dementia due to Alzheimer’s disease in some adults. This follows on from the US Food and Drug Administration (FDA)’s green light in .
However, NICE, which acts as the UK’s price watchdog, said that although the monthly injection slows disease progression by four to seven months, as demonstrated in the Phase III TRAILBLAZER-ALZ 2 (NCT04437511) study, there are “significant uncertainties about how much benefit donanemab provides, and how long this lasts for after stopping treatment”. It also said that more evidence is needed on the clinical and cost-effectiveness of Kisunla. A NICE committee also explained that one-third of patients in the trial had signs of brain swelling or brain bleeding, as determined by amyloid-related imagining abnormalities (ARIAs).
Similar concerns were raised in the FDA’s June 2024 convened to discuss the drug’s approval. Patients in Lilly’s trial were closely monitored due to this, with MRIs done at four, 12, 24, 52, and 76 weeks in addition to allowing for unscheduled MRIs at investigator discretion. This frequent monitoring can rack up , as wel.