OBJECTIVES

: In England there are currently four licensed treatments that provide symptomatic relief for patients with Alzheimer’s, the first of which became available in 1997 and for which patents expired between 2012 and 2014. The objective of this research was to assess prescribing trends and equity of access to drugs for dementia in primary care over a 4 year period from 2014 to 2018.

METHODS

: An analysis of NHS Digital Clinical Commissioning Group (CCG) prescribing data for the quarter January to March 2014 and for the same period in 2018.

RESULTS

: In the period January to March 2018 in the drugs for dementia category the number of drug items prescribed by CCGs in England had increased from 653,471 (average 3,054 per CCG) in 2014 to just under 1 million (average 4,377 per CCG), an increase of 41%. The cost of these drugs had decreased by 44% from just under £10m in 2014 to £5.9m as a result of patent expiries. The top 20 CCGs prescribed on average 8,030 items costing £131,862 in 2014 versus the bottom 20 CCGs which prescribed on average 527 items costing £6,486; a 15 fold difference. In 2018 the top 20 CCGs prescribed on average 10,211 (costing £72,036) versus an average of 1,191 (costing £5,791) in the bottom 20 CCGs; an 8.6 fold difference

CONCLUSIONS

: The treatment of dementia has been the focus of public interest and healthcare policy development for over a decade. Prescribing costs of drugs for dementia have decreased substantially in the last 4 years due to patent expiry. CCGs in England have reduced their expenditure in this area while increasing the number of prescribed items. Despite savings incurred, an 8 fold difference in equity of access to drugs for dementia can be seen between the highest and lowest prescribing CCGs in England.