My mother always told me to remember to play nice. When it comes to having access to quality-of-life drugs, however, Japanese pharmaceutical Eisai has decided it can't afford to be nice to NICE, or Britain's National Institute for Health & Clinical Excellence.

Last November NICE voted to prohibit the use of the acetyl cholinesterase inhibitors for patients with mild forms of Alzheimer's disease. The regulators said that at about $5 per day for treatment, it wasn't cost-effective enough to warrant the National Health Service paying, when only 15% to 50% of the patients responded favorably.

Naturally, the patients who were being shut out were enraged. Eisai, along with Pfizer (NYSE:PFE), which co-markets the drug under its brand name Aricept here in the U.S., have taken NICE to court. Joined by the Alzheimer's Society, it's the first time a legal challenge to a NICE ruling has reached that country's high court. There have been several failed appeals already in the lower courts.

It's not only Eisai and Pfizer that would benefit from a resumption of the drugs use. There are several inhibitors that have been banned. Also affected are Razadyne, by Johnson & Johnson (NYSE:JNJ), and Exelon, by Novartis (NYSE:NVS). Another drug that had been considered for the ban, Ebixa, by H. Lundbeck, will only be allowed in clinical trials in cases involving moderate to severe forms of Alzheimer's. Ebixa is the trade name for memantine, which is also sold in the U.S. as Namenda by Forest Labs (NYSE:FRX) and is not affected by the decision.

Critics have charged that NICE's decision condemns patients to getting worse before they're given access to treatment. While there is no cure for Alzheimer's, there's ample evidence that these drugs slow the progression of the disease, extending for a time the ability of afflicted patients to care for themselves, as well as relieving the burden on their caretakers.

Eisai's Aricept is the most-prescribed Alzheimer's treatment, and it's the only one that has won FDA approval to treat the full spectrum of Alzheimer's symptoms. Previously, it had been used for mild-to-moderate symptoms, while Namenda had been prescribed for moderate-to-severe symptoms. The two drugs were often prescribed together for treatment.

There have been more than 400 drugs reviewed by NICE since it was created in 1999, and only about 10 have been rejected by the agency. There have been restrictions placed on two-thirds of the drugs, and the advisory body has come under severe criticism for rationing out access to health care, as well as for assigning an arbitrary monetary amount to a person's quality of life, currently around $60,000 per quality-adjusted life year.

Genentech's (NYSE:DNA) breast cancer treatment Herceptin had also failed to win NICE approval, but when several patients challenged the agency in court last year, it reversed course and approved its use.

The U.K. is at the forefront of rigorous cost-benefit analysis for determining approval of drugs, and other countries are considering similar policies. That's what makes a decision here in favor of Eisai and Pfizer important because of the wide-reaching implications it will have down the road.

When it comes to getting its drugs to patients, there's no need to play nice.

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Fool contributor Rich Duprey owns shares of Eisai but does not have a financial position in any of the other stocks mentioned in this article. You can see his holdings here. The Motley Fool has a disclosure policy. Pfizer is an Inside Value recommendation. Johnson and Johnson is an Income Investor selection.