Villar Fernández I, Rabaneque Hernández M J, Armesto Gómez J, García Arilla E, Izuel Rami M
Servicio de Farmacia. Centro Neuropsiquiátrico Ntra. Sra. del Carmen. Garrapinillos (Zaragoza).
Neurologia. 2007 Jun;22(5):275-84.
To evaluate the consumption evolution and financial impact of specific treatments for Alzheimer's disease (AD) in Aragon (Spain), analyzing consumption patterns and trends, and to estimate the proportion of AD patients treated with these drugs.
Descriptive study of outpatient utilization of cholinesterase inhibitors and memantine (1996-2004), obtained from the drug packages dispensed by community pharmacists through prescriptions charged to the National Health Service. According to the defined daily doses (DDD) and expenditure data available, data were expressed in DDD per 1,000 inhabitants per day (DHD), DDD per 1,000 inhabitants older than 64 (DHD65), first-last year increase (%), drug consumption pattern, annual cost per inhabitant and daily treatment cost (DTC). To estimate the proportion of treated patients we compared the DHD65 data with the estimated AD prevalence.
Overall consumption of these drugs has increased from 0.026 DHD (1996) to 3.235 DHD (2004). Donepezil remains as the most prescribed, though it is proportionally decreasing as a result of the quick introduction of newer alternatives. Overall cost of the DHD dispensed in 2004 reached nearly 6 million euros. DTC decreased about 30% over the study period, but the total cost increased ninety-fold (sixty-fold when non-variable euros from 2004 were considered). According to our estimates, 34% of people with AD were receiving specific treatment.
There is a significant increase in the consumption and economical burden of these drugs, whose cost-effectiveness has been questioned in some studies. More studies including specific patient data are needed in order to identify individual characteristics and evaluate treatment appropriateness.
评估西班牙阿拉贡地区阿尔茨海默病（AD）特定治疗方法的使用演变及经济影响，分析使用模式和趋势，并估算接受这些药物治疗的AD患者比例。
对1996 - 2004年门诊使用胆碱酯酶抑制剂和美金刚的情况进行描述性研究，数据来自社区药剂师根据国家卫生服务处方配发的药品包装。根据既定日剂量（DDD）和可用支出数据，数据以每千居民每日DDD（DHD）、64岁以上每千居民DDD（DHD65）、首年 - 末年增长（%）、药物使用模式、人均年度成本和每日治疗成本（DTC）表示。为估算接受治疗患者的比例，我们将DHD65数据与AD估计患病率进行了比较。
这些药物的总体使用量从1996年的0.026 DHD增加到2004年的3.235 DHD。多奈哌齐仍是处方量最大的药物，但由于新替代药物的迅速引入，其比例在下降。2004年配发的DHD总成本接近600万欧元。在研究期间，DTC下降了约30%，但总成本增长了90倍（若考虑2004年不变欧元则为60倍）。根据我们的估计，34%的AD患者接受了特定治疗。
这些药物的使用和经济负担显著增加，其成本效益在一些研究中受到质疑。需要更多纳入特定患者数据的研究，以确定个体特征并评估治疗的适宜性。
