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Drugs for Alzheimer's disease: reduction in the number of prescriptions is too slow

A study conducted by the independent French medical journal Prescrire shows a reduction of only around 26% in the number of patients in France exposed to at least one Alzheimer's disease drug between 2012 and 2017. In approximately 3 out of 4 newly exposed patients, treatment lasted for more than 6 months, despite the proven harms.

In France, as far back as 2011, the pharmacoeconomic committee (Commission de la transparence) of the French National Authority for Health (Haute autorité de santé – HAS), which assesses the medical benefits of new drugs and provides recommendations concerning drug reimbursement, downgraded the medical benefit of medicines marketed to treat Alzheimer's disease from "significant" to "low". In March 2012, the reimbursement rate for these drugs was dropped from 65% to 15%, but in practice, for administrative reasons, these drugs were still 100% reimbursed. It was only in 2016 that the drugs' medical benefit was rated "insufficient", a prelude to being delisted in August 2018.

Prescrire's study of the French national health insurance system's data for the period 2012–2017 shows that the number of patients exposed in France fell from approximately 300 000 in 2011 to 200 000 in 2017. The number of patients newly exposed to at least one of these drugs fell by 22% between 2012 and 2017. But the majority of these patients – some 74% in 2012 and 70% in 2016 – were exposed for longer than six months, despite the proven harms.

It is likely that a more pronounced decrease in exposure has resulted from the withdrawal of all reimbursement, which came into effect in August 2018. However, it is already clear that market withdrawal would be the most effective regulatory measure for protecting patients from these drugs, which are more dangerous than useful.

©Prescrire 1 May 2019

"Drugs for Alzheimer's disease: reduction in the number of prescriptions too slow" Prescrire Int 2019; 28 (204): 138. (Pdf, subscribers only).

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See also:

Drugs for Alzheimer's disease:
finally delisted in France!  
(June 2018)

Towards better patient care:
drugs to avoid in 2019
Prescrire Int 2019;
28 (203): 108-1 - 108-10.