Summary

Although it is not known exactly how many Australians have dementia, it is estimated to affect up to 436,000 people. In 2017, dementia caused more than 13,700 deaths and was the second-leading cause of death in Australia, behind coronary heart disease (18,600 deaths). Dementia is the leading cause of death for females.

Dementia is not 1 specific disease, but a term used to describe a group of conditions characterised by the gradual impairment of brain function. There are many different forms of dementia—Alzheimer’s disease is the most common. Although dementia can affect younger people, it occurs mainly among those aged over 65, and is a major cause of disability and dependency among older people.

This report focuses on dispensing patterns for 4 types of anti-dementia medications, the associated costs to people and the Government, and other medications being taken.

Donepezil was the most commonly dispensed medication

In 2016–17 in Australia, anti-dementia medications were dispensed to about 58,500 people aged 30 and over. For about one-quarter (27%, 15,800) of these people, anti-dementia medications were dispensed for the first time.

Donepezil accounted for 65% of all anti-dementia medications dispensed, followed by Galantamine (15%), Rivastigmine (12%) and Memantine (8%). Donepezil was also the most commonly dispensed medication for people taking anti-dementia medications for the first time (73%), followed by Rivastigmine (12%), Galantamine (9%) and Memantine (6%).

$20 million was spent on anti-dementia medications in 2016–17

The total expenditure for anti-dementia medications, including Australian Government expenditure and patient contributions, was $20 million in 2016–17. Government expenditure comprised 80% of the total, with an average government subsidy of $29.11 per prescription and an average cost to people with dementia of $7.35 per prescription.

4 in 5 anti-dementia medications were prescribed by GPs

The majority (80%) of people to whom anti-dementia medications were dispensed were prescribed these medications at least once by general practitioners (GPs), followed by other medical specialists (42%) (people could be prescribed by more than 1 prescriber). Of the people who were prescribed anti-dementia medications by other medical specialists, over half were prescribed the medication by geriatric medicine specialists (55%), followed by psychiatry and neurology specialists (14% each) and internal medicine specialists (11%).

Medications for the cardiovascular system were dispensed to 3 in 4 people to whom anti-dementia medications were dispensed

Of the people to whom anti-dementia medications were dispensed, 77% were also supplied with medications for the cardiovascular system—Anatomical Therapeutic Chemical (ATC) 1—at least once during 2016–17, and 64% were supplied with medications for the alimentary tract and metabolism. The most common therapeutic subgroups (ATC2) of medications dispensed in addition to the anti-dementia medications were anti-bacterials for systemic use, dispensed at least once to 62% of those to whom anti-dementia medications were dispensed. This was followed by agents acting on the renin-angiotensin system (47%), which are often used to manage hypertension, and analgesics (painkillers such as codeine) (43%) (AIHW 2017a).