Medication cost of persons with dementia in primary care in Germany.

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. METHOD 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. CONCLUSION 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.