Up to 70,000 people in England who would have been eligible will be denied lecanemab.
David Thomas, Alzheimer's Research UK head of policy, predicted that the ruling will likely put the drug out of reach for "all but the most wealthy". He added: "If there's a licensed drug that is safe and effective, judged by the regulator, then that needs to be available to NHS patients, and not just those with the ability to pay."
Lecanemab, sold as Leqembi, is the world's first treatment proven to delay disease progression. Trials showed that it could slow cognitive decline by around five months.
It was yesterday approved by staff at the the Medicines and Healthcare products Regulatory Agency which decides whether drugs are safe and effective.
But the National Institute for Health and Care Excellence ruled its benefits were "too small to justify the costs" of making the treatment available on the NHS.
An expert committee found the high price of fortnightly infusions in hospital, intensive monitoring and "the relatively small benefits" meant that would not be a good use of taxpayer cash. The NHS bill for administering lecanemab and monitoring patients was estimated at £19,000 per person per year, not including the cost of the drug itself.
The price offered to the NHS by Japanese maker Eisai is confidential. Lecanemab is thought to cost £20,000 a patient a year in the US.
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