Tropical Journal of Pharmaceutical Research

Original Research Article | OPEN ACCESS

Drug cost optimization of cholinesterase inhibitor therapy in advanced dementia: Results of a prospective study of discontinuation

Ramon R Garcia-Garcia^1-3, Miguel Angel MA Calleja-Hernandez^3,4

¹Pharmacy Service, La Florida Residence, Alicante; ²Pharmacy Service, University Hospital of Torrevieja, Torrevieja; ³University of Granada, Granada; ⁴Pharmacy Service, University Hospital Virgen Macarena, Seville, Spain.

For correspondence:- Miguel Calleja-Hernandez Email: garciagaram@gmail.com Tel:+34627414254

Accepted: 24 July 2021 Published: 31 August 2021

Citation: Garcia-Garcia RR, Calleja-Hernandez MA. Drug cost optimization of cholinesterase inhibitor therapy in advanced dementia: Results of a prospective study of discontinuation. Trop J Pharm Res 2021; 20(8):1711-1714 doi: 10.4314/tjpr.v20i8.23

© 2021 The authors.
This is an Open Access article that uses a funding model which does not charge readers or their institutions for access and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0) and the Budapest Open Access Initiative (http://www.budapestopenaccessinitiative.org/read), which permit unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited..

Abstract

Purpose: To investigate the effect of discontinuing treatment with cholinesterase inhibitors (ChEIs) on drug costs in patients with advanced dementia.

Methods: Severe dementia patients receiving ChEI treatment for over 12 months (n = 43) aged over 65 years (mean age = 82.6 ± 7.5 years) were recruited from 8 nursing homes located in Alicante, Spain. ChEI treatment was discontinued in 23 patients. Here, we report the results from a cost-minimization analysis to evaluate the drug costs with a follow-up period of three months. The drug costs were prospectively analyzed based on drug acquisition costs.

Results: At the end of the follow-up, the mean monthly drug costs were €52.68 ± 22.48 in the discontinuation group and €122.54 ± 44.74 in the continuation group - a significant difference of means of -€69.86 (95 % CI, -91.24 to -48.48; p = 0.000). The monthly drug cost reduction for the ChEI discontinuation group was €1,533.35.

Conclusion: ChEI discontinuation appears to be a possible option for minimizing treatment costs in institutionalized patients with advanced dementia.

Keywords: Dementia, Cholinesterase inhibitors, ChEI, Medication discontinuation, Drug cost, Nursing homes