What is happening with not recommended drugs for dementia in Argentina? Prescription patterns and direct costs analysis

Abstract

OBJECTIVES: The only recommended pharmacological treatment for specific dementias are donepezil, galantamine, rivastigmine, and memantine (Recommended Drugs: RD). However, other drugs without recommendations (Not Recommended Drugs: NRD) are often used to treat patients with Cognitive Impairment (CI) in Argentina. The INSSJyP is the largest health insurance in Argentina. The objective of this study is to analyze the prescription pattern, cost and implications of NRD used for the treatment of CI in the INSSJyP.

MATERIALS: This is a retrospective, population-based study of the INSSJyP outpatients' prescriptions database for drugs usually prescribed for CI during 2015. These data were compared to the same database in 2009. The number of "prescriptions" always refers to dispensed packages.

RESULTS: A total of 3.255.438 packages of drugs usually indicated for CI were prescribed during 2015: 1.912.476 packages of RD (59%), and 1.342.962 packages of NRD (41%).Comparing the results with those obtained in 2009, there is a 148% gross increase in the prescription of both RD and NRD for CI, although the rates/1000 affiliates/year show a lesser rise for NRD (70.1%) compared to RD (103.9 %).The expenditure on CI drugs prescribed during 2015 was 77 millions USD. NRD cost represented approximately 20 millions USD.

CONCLUSION: Inappropriate drug use increases health costs in developing countries. We found a high number of patients with a probable diagnosis of CI treated with NRD. It is extremely relevant that all the healthcare professionals can update their knowledge and modified behavioural insights about appropiate prescription for specific dementias.