Prescription Patterns of Medications for Alzheimer’s Disease in Japan from 2010 to 2015: A Descriptive Pharmacy Claims Database Study

Abstract

IntroductionAlthough four kinds of Alzheimer’s disease (AD) drugs are available at present there was only one drug until 2011 in Japan. This study aimed to elucidate prescription trends of these medications for AD in Japanese outpatients before and after the new drug releases in 2011.MethodsThis descriptive study of pharmacy claims databases analyzed outpatient prescription data from community pharmacies across Japan. The study patients were 20 years or older and first administered medications for AD (donepezil, memantine, rivastigmine, or galantamine) between January 2010 and September 2014. They were grouped on the basis of the year of their initial medications for AD administration into the 2010–2011 and 2012–2014 groups (1 and 2, respectively) and their characteristics and AD treatments were summarized by group. The subanalyses used a multivariable logistic regression model to examine the relationship between patient characteristics and discontinuation or change to combination therapy within a year.ResultsA total of 103,592 patients (group 1 and 2, 28,581 and 75,011, respectively) were prescribed medications for AD during the study period. The group 1 and 2 mean ± standard deviation (SD) ages were 79.6 ± 7.4 and 80.9 ± 7.3 years while female patients constituted 64.0% and 64.5%, respectively. Furthermore, in groups 1 and 2 patients, 99.0% and 94.3% received a medication for AD monotherapy, 92.3% and 59.6% were prescribed donepezil, and 40.5% and 41.5% discontinued treatment within a year, respectively. The subanalyses suggest that being at least 85 years old strongly correlated with treatment discontinuation and change to combination therapy within a year.ConclusionAlthough the prescription proportions of the various medications for AD have changed since 2011, no apparent changes occurred in the patient characteristics of those who initiated AD treatment between 2010–2011 and 2012–2014.

Diabetes mellitus and risk of early‐onset Alzheimer's disease: a population‐based case–control study

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Adherence and Concomitant Medication Use among Patients on Warfarin Therapy: Insight from a Large Pharmacy Dispensing Database in Japan

“…We used data obtained from three nationwide pharmacy chains in Japan (Ain Pharmaciez Inc., Kraft Inc., and Nihon Chouzai Co., Ltd.) 7,8) ; the data comprised dispensing records from more than seven million outpatients in 2012, covering approximately 4% of all outpatient dispensations in Japan that year. The patient demographic data are well matched with the entire population of Japan, but pharmacies are typically located in urban areas.…”

Antipsychotic use and related factors among people with dementia aged 75 years or older in Japan: A comprehensive population‐based estimation using medical and long‐term care data

“…Indeed, antipsychotics are associated with greater risks for mortality and cerebrovascular events, which has led regulatory agencies to issue warnings or required pharmaceutical companies to add precautions about the use of antipsychotics for people with dementia . However, antipsychotics have still been commonly prescribed in older adults with dementia in Japan and in overseas countries, even after the issue of such warnings or precautions.…”

“…There have been several studies on the use of antipsychotics in older people with dementia in Japan. Based on analyses of large‐scale medical claims data, the prevalence of antipsychotic use among people prescribed antidementia drugs ranged from 16.8% to 24.9%. These studies limited their study cohort to those prescribed antidementia drugs partly because a diagnosis of dementia in medical claims is not considered reliable.…”