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Post-market utilization patterns of Alzheimer’s disease treatments in South Korea: comparison with countries with universal health coverage

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Purpose

This study aimed to compare the utilization of Alzheimer’s disease (AD) treatments, donepezil, galantamine, rivastigmine, and memantine, in Korea with Australia and other countries with universal health coverage.

Methods

Reimbursement criteria and the patent status of four AD treatments in Korea and Australia were reviewed. The monthly spending and utilization of the treatments were extracted from the national electronic database in Korea and Australia. The defined daily dose per 1000 elderly population per day (DDD/1000e/day) were calculated from July 2008 to June 2019. Annual cost trends of Norway and England were compared with Korea and Australia.

Results

With the highest share of the use of donepezil in both countries, the cost and utilization of AD treatments in Korea increased more rapidly and remained higher than Australia. The cost of AD treatments in Korea increased by 15.5% every year during the study period, while the spending of the same drugs in Australia decreased by 10.5% annually. The utilization in DDD/1000e/day of AD treatments in Korea increased by 18.3% annually compared with 1.4% in Australia. When compared with Norway and England, countries with similar universal health coverage (UHC) system and elderly polupation, the cost of AD treatments in Korea was still higher with the opposite trend from other countries.

Conclusions

Despite the similar UHC systems, there were considerable differences in the post-market utilization of AD treatments in Korea from Australia and other countries. This results can be attributed to differences in re-assessment system, pricing and reimbursement policies, and prescribing culture. This study provides a baseline to explore more comprehensive cross-country studies on rational use of medicines.

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Data Availability

Data will be made available on responsible request.

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Acknowledgments

Author Lisa Kalisch Ellett is supported by a National Health and Medical Research Council and Australian Research Council (NHMRC-ARC) Dementia Research Development Fellowship (Grant identification number APP1101788).

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. College of Pharmacy, Woosuk University, Wanju, Republic of Korea

    Hye-Jae Lee

  2. Quality Use of Medicines and Pharmacy Research Centre, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia

    Hye-Jae Lee, Elizabeth E. Roughead & Lisa Kalisch Ellett

  3. National Health Insurance Research Institute, National Health Insurance Service, Wonju, Republic of Korea

    Hye-Jae Lee & Jihye Lee

  4. College of Pharmacy, Yonsei Institute for Pharmaceutical Research, Yonsei University, Seoul, Republic of Korea

    Euna Han

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  1. Hye-Jae Lee
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  2. Elizabeth E. Roughead
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  4. Jihye Lee
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Contributions

HJL and EER conceived of the presented idea. HJL and JHL performed data collecting, cleaning and analysis and LKE verified the analytical methods. HJL performed literature review. HJL and LKE drafted the manuscript. All authors discussed the results and commented on the manuscript.

Corresponding author

Correspondence to Hye-Jae Lee.

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Conflict of interest

HJL and JHL were employees of National Health Insurance Service when this research was done. Other authors declare that they have no competing interests.

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Lee, HJ., Roughead, E.E., Han, E. et al. Post-market utilization patterns of Alzheimer’s disease treatments in South Korea: comparison with countries with universal health coverage. Eur J Clin Pharmacol 77, 921–929 (2021). https://doi.org/10.1007/s00228-020-03065-x

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  • DOI: https://doi.org/10.1007/s00228-020-03065-x

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