This study sheds light on the development of the use of medicinal products for Alzheimer’s disease during the period September 1997 until April 2003. Four medicinal products are used for treating Alzheimer’s disease – 3 cholinesterase inhibitors (Aricept®, Exelon® and Reminyl®) and a glutamine antagonist (Exiba®). The first medicinal product for Alzheimer’s disease was marketed in September 1997, whereas Exiba® was marketed in August 2002.
Sales, measured in DKK and DDD (defined daily doses), have risen throughout the entire period. During the period 1999-2002 sales have risen by approximately 50 per cent every year compared to the previous year. In 2002 the turnover of dementia products constituted DKK 67m and a quantity consumption of 1.0 DDD per 1,000 inhabitants. Aricept® holds the largest market share. During the first 4 months of 2003 Aricept® constituted 83 per cent of the quantity consumption, while Exelon® constituted 2.6 per cent, Reminyl® 8.7 per cent and Exiba® 5.8 per cent.
A total of 10,536 people were treated during the period studied. In 2002 the number of users was 6,771. From 1999 to 2000 the number of users had risen by 41 per cent, from 2000 to 2001 by 48 per cent and from 2001 to 2002 by 49 per cent. Moreover, the number of people in medical treatment for Alzheimer’s disease increases with age and the prevalence is higher in women than in men. The prevalence for 2002 is 1.9 per cent for women and 1.5 per cent for men aged 85-89 years, which is the age group with the highest prevalence. From age 60 and above the prevalence rises significantly. At the ages 60-64 the prevalence is approximately 0.05 per cent for both sexes.
Duration of treatment is calculated for people who have terminated medical treatment for Alzheimer’s disease (34 per cent of all users in the period studied) and a preliminary duration of treatment for people who are still treated (the remaining 66 per cent). Of the people who are no longer in treatment, 46 per cent were treated 0-6 months and 17 per cent were treated 7-12 months. 17 per cent had been in treatment for more than 2 years. Corresponding figures for people still treated are 23 per cent and 19 per cent for 0-6 months and 7-12 months respectively, whereas 32 per cent had been treated for more than 2 years.
Most users (93 per cent) have only been treated with one dementia product – 90 per cent with a cholinesterase inhibitor and 3 per cent with Exiba®. 4 per cent used prescriptions for more than one cholinesterase inhibitor and 3 per cent used prescriptions for one or more cholinesterase inhibitors and Exiba®. It is estimated that at least 12 per cent of those who have been or are treated with Exiba® have been or are in combination treatment with Exiba® and a cholinesterase inhibitor, but it may be up to 29 per cent.
Of the cholinesterase inhibitors, Exelon® is the least expensive preparation to be treated with and Reminyl® is the most expensive.