Memantine (Ebixa)

Following a resubmission Not recommended for use within NHS Scotland

This is currently the only agent licensed in UK for use in moderately severe to severe Alzheimer's disease. There is only one pivotal trial and it involves 252 patients. It showed a statistically significant benefit over placebo of 0.3 in the Clinician’s Interview Based Impression of Change (CIBIC+) on a scale of 1 – 7, which includes care givers’ views. It also showed a reduction in the Alzheimer’s Disease Cooperative Study Activities of Daily Living Inventory (ADCS-ADL) of 3.4 on a 54 point range. These results show that the magnitude of any effect is small, the clinical importance of which is unclear. No target sub group of the population could be identified as potential responders nor was there evidence of an optimal duration of treatment.

The economic case submitted by the manufacturer does not support a recommendation that use of this drug would be cost effective relative to standard practice in Scotland.