title: Pharmaceutical consumption and cost in patients with dementia: A longitudinal study by the Registry of Dementias of Girona (ReDeGi) in Catalonia (Spain).
abstract: OBJECTIVE
  Drug spending increases exponentially from the age of 65-70 years, and dementia is one of the diseases significantly contributing to this increase. Our aim was to describe pharmaceutical consumption and cost in patients with dementia, using the Anatomical Therapeutic Chemical (ATC) classification system. We also assessed the evolution of costs and consumption, and the variables associated to this evolution during three years.
  
  
  METHODS
  Three years prospective cohort study using data from the ReDeGi and the Health Region of Girona (HRG) Pharmacy Unit database from the Public Catalan Healthcare Service (PCHS). Frequency of consumption and costs of ATC categories of drugs were calculated.
  
  
  RESULTS
  Sample of 869 patients with dementia, most of them with a diagnosis of degenerative dementia (72.6%), and in a mild stage of the disease (68.2%). Central nervous system (CNS) drugs had the highest consumption rate (97.2%), followed by metabolic system drugs (80.1%), and cardiovascular system drugs (75.4%). Total pharmaceutical cost was of 2124.8 € per patient/year (standard deviation (SD)=1018.5 €), and spending on CNS drugs was 55.5% of the total cost. After 36 months, pharmaceutical cost increased in 694.9 € (SD=1741.9), which was associated with dementia severity and institutionalization at baseline.
  
  
  CONCLUSIONS
  Pharmaceutical consumption and costs are high in patients with dementia, and they increase with time, showing an association with baseline dementia severity and institutionalization. CNS drugs are the pharmaceuticals with highest prescription rates and associated costs.
authors.affiliation: IAS Research Unit, [Girona Biomedical Research Institute] IDIBGI, Girona, Catalonia, Spain.
authors.forename: O
authors.initials: O
authors.lastname: Turró-Garriga
authors.affiliation: IAS Research Unit, [Girona Biomedical Research Institute] IDIBGI, Girona, Catalonia, Spain. Electronic address: laia.calvo@ias.scs.es.
authors.forename: L
authors.initials: L
authors.lastname: Calvó-Perxas
authors.affiliation: Neurology Unit, Hospital de Figueres, Figueres, Catalonia, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Albaladejo
authors.affiliation: Dementia Unit, Serveis de Salut Integrats del Baix Empordà, Palamós, Catalonia, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Alsina
authors.affiliation: Neurology Department, Hospital de Campdevànol, Campdevànol, Catalonia, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Cuy
authors.affiliation: Dementia Unit, Hospital de Santa Caterina, Salt, Catalonia, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Llinàs-Reglà
authors.affiliation: Pharmacy Unit, Health Region of Girona, Catalonia, Spain.
authors.forename: A M
authors.initials: AM
authors.lastname: Roig
authors.affiliation: Neurodegenerative Disease Unit, Hospital Universitari Dr. Josep Trueta, Girona, Catalonia, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Serena
authors.affiliation: Neurology Department, Hospital d'Olot, Olot, Catalonia, Spain.
authors.forename: N
authors.initials: N
authors.lastname: Vallmajó
authors.affiliation: Geriatrics and Neurology Department, Hospital de Blanes, Blanes, Catalonia, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Viñas
authors.affiliation: IAS Research Unit, [Girona Biomedical Research Institute] IDIBGI, Girona, Catalonia, Spain; Dementia Unit, Hospital de Santa Caterina, Salt, Catalonia, Spain; Department of Medicine, University of Girona, Girona, Catalonia, Spain.
authors.forename: S
authors.initials: S
authors.lastname: López-Pousa
authors.affiliation: IAS Research Unit, [Girona Biomedical Research Institute] IDIBGI, Girona, Catalonia, Spain; Dementia Unit, Hospital de Santa Caterina, Salt, Catalonia, Spain; Department of Medicine, University of Girona, Girona, Catalonia, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Vilalta-Franch
authors.affiliation: IAS Research Unit, [Girona Biomedical Research Institute] IDIBGI, Girona, Catalonia, Spain; Department of Medicine, University of Girona, Girona, Catalonia, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Garre-Olmo
mesh_terms: D000328:Adult; D000368:Aged; D003704:Dementia / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology*; D016527:Drug Costs; D011307:Drug Prescriptions / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011446:Prospective Studies; D011619:Psychotropic Drugs / Q000191:economics / Q000627:therapeutic use*; D012042:Registries; D013030:Spain / Q000453:epidemiology
chemical_list: D011619:Psychotropic Drugs
keywords: Cost; Dementia; Drug consumption; Longitudinal; Registry