title: Medication cost of persons with dementia in primary care in Germany.
abstract: BACKGROUND
  Results of cost-of-illness studies in dementia have shown a considerable divergence in costs of medication for persons with dementia. However, detailed economic analyses of medication costs for community-dwelling persons with dementia are currently still missing, especially on the basis of primary data.
  
  
  OBJECTIVE
  To determine medication cost, cost per drug, and number of drugs taken of community-dwelling persons with dementia and analyze their associated factors; to estimate the current price reduction of anti-dementia drugs due to implementation of low-priced generics.
  
  
  METHODS
  The present analysis included 205 patients screened positive for dementia. Medication data were assessed within a medication review. To estimate the cost effect of implementing generics, the most favorable equivalent generic was assigned to each anti-dementia drug. Factors associated with medication cost, cost per drug, and number of drugs taken were evaluated using multiple regression models.
  
  
  RESULTS
  Medication cost and cost per drug were higher and the number of taken drugs lower in advanced stages of cognitive impairment. Prescription of anti-dementia generics could decrease overall medication cost by 28%. Medication cost was associated with number of diagnoses, deficits in activities of daily living, and age. Dementia severity was related to cost per drug and number of drugs taken.
  
  
  CONCLUSIONS
  Medication cost increases with the number of diagnoses and growing deficits in activities of daily living and decreases with age. Severely cognitively impaired persons are treated with a small number of high-priced drugs, which could suggest inadequate medication of multimorbid persons.
authors.affiliation: German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Michalowsky
authors.affiliation: German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany.
authors.forename: Tilly
authors.initials: T
authors.lastname: Eichler
authors.affiliation: German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany.
authors.forename: Jochen René
authors.initials: JR
authors.lastname: Thyrian
authors.affiliation: German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Hertel
authors.affiliation: German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany.
authors.forename: Diana
authors.initials: D
authors.lastname: Wucherer
authors.affiliation: Department of General Business Administration and Health Care Management, Ernst-Moritz-Arndt-University Greifswald, Greifswald, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Laufs
authors.affiliation: Department of General Business Administration and Health Care Management, Ernst-Moritz-Arndt-University Greifswald, Greifswald, Germany.
authors.forename: Steffen
authors.initials: S
authors.lastname: Fleßa
authors.affiliation: German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, Ernst-Moritz-Arndt-University Greifswald, Greifswald, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Hoffmann
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D014150:Antipsychotic Agents / Q000191:economics* / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D003704:Dementia / Q000188:drug therapy* / Q000191:economics* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D009483:Neuropsychological Tests; D011320:Primary Health Care
chemical_list: D014150:Antipsychotic Agents
keywords: Dementia; drug substitution; drug therapy; economics; pharmaceutical economics