NICE has recommended to the NHS in England and Wales that atypical anti-psychotics should be considered alongside existing "traditional" typical medicine as one of the first choice options to treat people newly diagnosed with schizophrenia. The newer atypicals are believed to have fewer and less serious side-effects than the older style typical drugs.
Commenting on the decision, the Director of Communications, Anne-Toni Rogers said: "NICE estimates that by making these drugs available as one of the options for people newly diagnosed with schizophrenia, or for those who are currently experiencing unacceptable side effects from their existing treatment the increase in drug costs to the NHS, in England and Wales, will be about £70 million per year."
However, she said, the use of the newer medicines is expected to result in a shift away from inpatient hospital care to residential or community care, which was more expensive: "Ten years ago it was estimated that the indirect costs of schizophrenia in the UK were about £1.7 billion. If the use of these newer agents, alongside the more traditional medicines, enables more individuals with schizophrenia to live independently there could be substantial savings to the economy as a whole."
Here are the views of some of the key players in the mental health debate.
"The NICE recommendations are great news for everyone involved with mental health and show that NICE has put care above cost in the treatment of this very vulnerable group. Whether Health Authorities and Trusts will be so quick to implement the guidelines, however, is another matter. All professionals will need to keep up the pressure to ensure the guidelines become a reality for patients."
Martin Deahl, Consultant Psychiatrist
"It's about time really. Everyone is talking about the 'new' atypicals but they have been around for 10 years actually, so they are not particularly new. It is really outrageous that it has taken so long for successive governments to come to this decision, which I think to most people is a fairly obvious conclusion. Although they are more expensive they are still not that expensive - considering the much-reduced side-effects, compliance and all the other issues involved in taking medication _ and that will save far more than the cost of funding the medication."
Lynne Jones MP, Co-Chair of the APPG on Mental Health
"We presented NICE with hard evidence from the real-life experiences of thousands of people who live with schizophrenia - the largest survey of its kind ever. People have been telling us for years that old-style 'typical' medication had severe unacceptable side effects but they were denied choice by cost restrictions. Now NICE has come out with clear guidance that cannot be ignored. People must be offered a choice to suite them. From today, only the best will do. Second-class citizenship for people with severe mental illness is no longer an option."
Cliff Prior, Chief Executive of the National Schizophrenia Fellowship (Rethink)
"Currently, many schizophrenic patients feel forced to trade off improved mental well-being whilst on treatment, against possible drug side effects which can be intolerable. As a result, many abandon treatment and follow-up. For those patients these newer type of drugs show a distinct improvement, with more manageable side-effects, leading them to take their full treatment. Improving mental health services is a key government priority and the NHS must ensure that the most clinically and cost-effective drugs are available for service users"
Lord Hunt, Health Minister
"I very much welcome this decision, but it is long overdue. The Conservative Party and mental health charities have been pressing for it for some time. These new atypical antipsychotics have significantly fewer of the distressing and damaging side-effects of older drugs. Labour has made NICE an arm's length rationing service. It is outrageous that one of the most innovative countries in the world for new products has one of the slowest roll out times, denying vulnerable people access to improved treatment. We will now have to see if the government provides the resources necessary to implement this change. Labour claims that mental health is a priority but it doesn't feel like it for patients or practitioners in the field. This decision has been under review for almost two years and it is clear that millions of pounds are leaking out of mental health into other priorities, and that unacceptable delays are still occurring. A Mental Health Bill was promised years ago and still hasn't been delivered."
Oliver Heald MP, Conservative Health Spokesperson
"Weight gain and fits may be common and more severe with atypicals but this is not mentioned by NICE. The weight gain, often huge, can cause diabetes and heart disease. As it is expected that the increased use of atypical drugs will lead to a decreased need for hospital beds one must wonder to what extent the patients will actually be monitored by the clinician and the key worker so that 'both therapeutic properties and tolerability of the drug (are known) on an ongoing basis'. Surely this will be a difficult task when the patient is in the community?"
Gywnneth Hemmings, Honorary Secretary, Schizophrenia Association of Great Britain (SAGB)
"In a decent society the public should be able to expect a drug which will treat the condition and offer the best quality of life. It is shameful that this hasn't happened in the area of mental health."
Sandra Gidley MP, Lib Dem Health Spokeswomen
"Speaking not just from personal experience, the NICE ruling represents the only acceptable outcome and decision for treatment - not just within the field of schizophrenia but for all other major conditions."
Tim Newey, Actor and Artist
