Original Title: Diagnóstico y consumo de fármacos para la enfermedad de Alzheimer en el País Vasco

Authors' objectives: For the diagnostic area: (1) to know how Alzheimer's diagnosis is being carried out in the Basque Autonomous Community (CAV); (2) describe the standards established by the clinical practice guidelines for the diagnosis of AD and (3) identify areas for improvement in the diagnosis of Alzheimer's in our healthcare context. For the treatment area: (1) to know the evolution in the consumption of specific drugs for AD in the CAV; (2) analyze the differences in consumption between the three historical territories of the CAV and (3) assess the economic impact that the consumption of these drugs entails.

Authors' results and conclusions: Diagnosis Area - Systematic review: Three guidelines were selected from a total of five for their high methodological quality. These guidelines demonstrate that there is an important agreement regarding most of the recommendations for the diagnosis of AD. - Questionnaire on the methods used for the diagnosis of AD in the CAV: The results indicate that the Mini-Mental test (MMSE) is the most widely used for screening for AD. Furthermore, there is great agreement in the diagnostic techniques used, with CT being the technology most commonly used in clinical practice, while MRI and functional imaging techniques are mainly limited to differential diagnosis. - After comparing the clinical practice with the proposed recommendations, it is concluded that there is a high level of adherence between the CPG recommendations and the clinical practice reported by the experts. Treatment area - During the period 2006 to 2011, the consumption of these drugs has experienced, in absolute terms, a growth of close to 60%, reaching 4.8 million defined daily doses (DDD) in 2011 compared to 3 million in the year 2006. This increase varies from important mode according to the evaluated drug: donepezil 20%, rivastigmine 106%, galantamine 47% and memantine 81%. - It is observed that consumption has increased in the three historical territories , although unevenly, with a total increase for the period studied of 16%, 50% and 57% for Araba, Bizkaia and Gipuzkoa respectively. - The pharmaceutical expenditure associated with these drugs has also increased by more than 56%, from 11.5 million euros in 2006 to 18.1 million in 2011. This increase is mainly due to a higher consumption of galantamine and memantine.

Authors' methods: For the diagnostic - Systematic review of the CPGs that address the diagnosis of AD - Evaluation of the methods used for the diagnosis of AD in the CAV by means of an email survey of specialists in neurology with extensive experience in the diagnosis and treatment of AD. - Comparison of the usual practice with the concordant recommendations between the different guides to identify areas for improvement. For the treatment - Retrospective descriptive study on the consumption of drugs for the treatment of AD in people over 60 years of age. - Analysis of the economic impact of consuming these drugs.

Project Status: Completed

Year Published: 2012

URL for published report: https://www.euskadi.eus/contenidos/informacion/2012_osteba_publicacion/es_def/adjuntos/eku_12_03_farm_alzhei.pdf

English language abstract: There is no English language summary available

Publication Type: Full HTA

Country: Spain

Organisation Name: Basque Office for Health Technology Assessment

Contact Address: C/ Donostia – San Sebastián, 1 (Edificio Lakua II, 4ª planta) 01010 Vitoria - Gasteiz

Contact Name: Lorea Galnares-Cordero

Contact Email: lgalnares@bioef.eus

Copyright: <p>Osteba (Basque Office for Health Technology Assessment) Health Department of the Basque Government</p>