OBJECTIVES : Korea has limited post-market review systems and over the past decade the spending of some pharmaceuticals has skyrocketed. Given donepezil has been the most consumed medicine and increased with the fast rate among the Korean elderly population, this study aimed to compare the post-market utilization of four Alzheimer’s Disease (AD) treatments with Australia, which has established well-organized post-market review systems.

METHODS : The nationwide pharmaceutical utilization of donepezil, galantamine, rivastigmine, and memantine were extracted from National Health Insurance claims data in Korea and Pharmaceutical Benefits Scheme data in Australia. The time trends of the spending, utilization, and unit cost of each treatment were examined on a monthly basis from 2008 to 2019.

RESULTS : The spending of AD treatments in Korea has increased drastically, while it has dropped by more than half in Australia. Provided a similar or lower prevalence of AD between Korea and Australia, the population standardized utilization measured by a defined daily dose/1,000/day of AD treatments in Korea has shoot up, while that of Australia remains static. The unit costs of treatments are higher in Korea than in Australia.

CONCLUSIONS : This study revealed that much more people with dementia in Korea are treated with AD treatments with higher prices of medications than in Australia. Without systems to re-assessment of the post-market utilization, the sustainability of public funding can be threatened as well as the ill health caused by inappropriate utilization of medicines. Korea needs a further post-market review on the cost-effectiveness and health outcomes.