Abstract

Introduction. Alzheimer’s disease (AD) is neurodegenerative disorder which progressively weakens the patients’ cognitive and functional abilities and increases care-dependence. There are four drugs registered in Estonia for AD treatment: memantine, donepezil, galantamine, rivastigmine.
Objectives. The aim of this study was to analyse the real usage of the mentioned medicines, to evaluate healthcare costs for the AD patients in 2004 and to predict costs for the Estonian Health Insurance Fund (EHIF), if memantine were included in the 75% reimbursement list.
Material and methods. The databases of the prescriptions, healthcare invoices and temporary work disability payments of the EHIF were analyzed.
Results. The total cost of the mentioned four drugs prescribed in 2004 for the AD patients was 770 512 EEK. From this sum 138 341 EEK (17.9%) were compensated by the EHIF. Altogether 134 916 EEK were paid as the work disability payment. The cost of hospitalisation per  AD patient was 9 392 EEK. The nursing care costs of the AD patients paid by the EHIF in 2004 were 10 453 EEK. According to the available databases, total healthcare costs for the AD patients in 2004 were 13 891 811 EEK, of which hospitalisation costs account for the largest proportion (56%). Drug-related expenditure constitutes 12%. Adequate treatment with memantine per AD patient saves up to 14 017 EEK of EHIF costs for hospitalisation, nursing care and out-patients’ related expenditures. Introduction of memantine in the 75% reimbursement list would cost the EHIF 13 703 EEK per treated patient per year. Hence, it would save the EHIF 314 EEK per each patient annually.
Conclusions. Treatment of the AD with memantine is cost-effective. 75% reimbursement of memantine would save the direct costs of the EHIF. Considering that longterm functional independence reduces other indirect costs for patients’ care-holders and family members, it is clear that the EHIF’s costs would be reduced even more.