Skip to main content
Top
Published in: BMC Neurology 1/2016

Open Access 01-12-2016 | Research article

The impact of dementia on drug costs in older people: results from the SNAC study

Authors: Anders Sköldunger, Johan Fastbom, Anders Wimo, Laura Fratiglioni, Kristina Johnell

Published in: BMC Neurology | Issue 1/2016

Login to get access

Abstract

Background

We aimed to investigate the impact of dementia on drug costs in older people, after adjustment for socio-demographic factors, residential setting and co-morbidities.

Methods

We included 4 129 individuals aged ≥ 60 years from The Swedish National Study on Aging and Care (SNAC) in Kungsholmen and Nordanstig 2001–2004. A generalized linear model (GLM) was used to investigate how much dementia was associated with drug costs.

Results

Overall drug costs for persons with and without dementia were 6147 SEK (816 USD) and 3810 SEK (506 USD), respectively. The highest drug cost was observed for nervous system drugs among persons with dementia. The adjusted GLM showed that dementia was not associated with higher overall drug costs (β = 1.119; ns). Comorbidities and residential setting were the most important factors for overall drug costs.

Conclusion

We found that the observed higher overall drug costs for persons with dementia were due to comorbidities and residential setting.
Literature
2.
go back to reference Skoldunger A, Wimo A, Johnell K. Net costs of dementia in Sweden - An Incidence Based 10 Year Simulation Study. Int J Geriatr Psychiatry. 2012;27:1112–7.PubMedCrossRef Skoldunger A, Wimo A, Johnell K. Net costs of dementia in Sweden - An Incidence Based 10 Year Simulation Study. Int J Geriatr Psychiatry. 2012;27:1112–7.PubMedCrossRef
3.
go back to reference Wimo A, Winblad B, Jönsson L. The worldwide societal costs of dementia: Estimates for 2009. Alzheimers Dement. 2010;6:98–103.PubMedCrossRef Wimo A, Winblad B, Jönsson L. The worldwide societal costs of dementia: Estimates for 2009. Alzheimers Dement. 2010;6:98–103.PubMedCrossRef
4.
go back to reference Wimo A, Jonsson L, Bond J, Prince M, Winblad B. The worldwide economic impact of dementia 2010. Alzheimers Dement. 2013;9(1–11):e13. Wimo A, Jonsson L, Bond J, Prince M, Winblad B. The worldwide economic impact of dementia 2010. Alzheimers Dement. 2013;9(1–11):e13.
5.
go back to reference Johnell K, Fastbom J. Comparison of Prescription Drug Use between Community-Dwelling and Institutionalized Elderly in Sweden. Drugs Aging. 2012;29:751–8.PubMedCrossRef Johnell K, Fastbom J. Comparison of Prescription Drug Use between Community-Dwelling and Institutionalized Elderly in Sweden. Drugs Aging. 2012;29:751–8.PubMedCrossRef
6.
go back to reference Hovstadius B, Astrand B, Persson U, Petersson G. Acquisition cost of dispensed drugs in individuals with multiple medications--a register-based study in Sweden. Health Policy. 2011;101:153–61.PubMedCrossRef Hovstadius B, Astrand B, Persson U, Petersson G. Acquisition cost of dispensed drugs in individuals with multiple medications--a register-based study in Sweden. Health Policy. 2011;101:153–61.PubMedCrossRef
7.
go back to reference Shi S, Morike K, Klotz U. The clinical implications of ageing for rational drug therapy. Eur J Clin Pharmacol. 2008;64:183–99.PubMedCrossRef Shi S, Morike K, Klotz U. The clinical implications of ageing for rational drug therapy. Eur J Clin Pharmacol. 2008;64:183–99.PubMedCrossRef
8.
go back to reference Budnitz DS, Lovegrove MC, Shehab N, Richards CL. Emergency hospitalizations for adverse drug events in older Americans. N Engl J Med. 2011;365:2002–12.PubMedCrossRef Budnitz DS, Lovegrove MC, Shehab N, Richards CL. Emergency hospitalizations for adverse drug events in older Americans. N Engl J Med. 2011;365:2002–12.PubMedCrossRef
9.
go back to reference Marengoni A, Winblad B, Karp A, Fratiglioni L. Prevalence of chronic diseases and multimorbidity among the elderly population in Sweden. Am J Public Health. 2008;7:1198–2000.CrossRef Marengoni A, Winblad B, Karp A, Fratiglioni L. Prevalence of chronic diseases and multimorbidity among the elderly population in Sweden. Am J Public Health. 2008;7:1198–2000.CrossRef
10.
go back to reference Haasum Y, Fastbom J, Fratiglioni L, Kareholt I, Johnell K. Pain treatment in elderly persons with and without dementia: a population-based study of institutionalized and home-dwelling elderly. Drugs Aging. 2011;28:283–93.PubMedCrossRef Haasum Y, Fastbom J, Fratiglioni L, Kareholt I, Johnell K. Pain treatment in elderly persons with and without dementia: a population-based study of institutionalized and home-dwelling elderly. Drugs Aging. 2011;28:283–93.PubMedCrossRef
11.
go back to reference Kales HC, Kim HM, Zivin K, Valenstein M, Seyfried LS, Chiang C, Cunningham F, Schneider LS, Blow FC. Risk of mortality among individual antipsychotics in patients with dementia. Am J Psychiatry. 2012;169:71–9. Kales HC, Kim HM, Zivin K, Valenstein M, Seyfried LS, Chiang C, Cunningham F, Schneider LS, Blow FC. Risk of mortality among individual antipsychotics in patients with dementia. Am J Psychiatry. 2012;169:71–9.
12.
go back to reference Rochon PA, Normand SL, Gomes T, Gill SS, Anderson GM, Melo M, Sykora K, Lipscombe L, Bell CM, Gurwitz JH. Antipsychotic therapy and short-term serious events in older adults with dementia. Arch Intern Med. 2008;168:1090–6. Rochon PA, Normand SL, Gomes T, Gill SS, Anderson GM, Melo M, Sykora K, Lipscombe L, Bell CM, Gurwitz JH. Antipsychotic therapy and short-term serious events in older adults with dementia. Arch Intern Med. 2008;168:1090–6.
13.
go back to reference Sterke CS, van Beeck EF, van der Velde N, Ziere G, Petrovic M, Looman CW, et al. New insights: dose-response relationship between psychotropic drugs and falls: a study in nursing home residents with dementia. J Clin Pharmacol. 2012;52:947–55.PubMedCrossRef Sterke CS, van Beeck EF, van der Velde N, Ziere G, Petrovic M, Looman CW, et al. New insights: dose-response relationship between psychotropic drugs and falls: a study in nursing home residents with dementia. J Clin Pharmacol. 2012;52:947–55.PubMedCrossRef
14.
go back to reference Skoldunger A, Johnell K, Winblad B, Wimo A. Mortality and treatment costs have a great impact on the cost-effectiveness of disease modifying treatment in Alzheimer’s disease--a simulation study. Curr Alzheimer Res. 2012;10:207–16.CrossRef Skoldunger A, Johnell K, Winblad B, Wimo A. Mortality and treatment costs have a great impact on the cost-effectiveness of disease modifying treatment in Alzheimer’s disease--a simulation study. Curr Alzheimer Res. 2012;10:207–16.CrossRef
15.
go back to reference Fastbom J, Giron M. Drug costs in dementia care. In: Wimo A, Jönsson B, Karlsson G, Winblad B, editors. Health Economics of Dementia. Chichester: John Wiley & Sons; 1998. p. 285–98. Fastbom J, Giron M. Drug costs in dementia care. In: Wimo A, Jönsson B, Karlsson G, Winblad B, editors. Health Economics of Dementia. Chichester: John Wiley & Sons; 1998. p. 285–98.
16.
go back to reference Lagergren M, Fratiglioni L, Hallberg IR, Berglund J, Elmstahl S, Hagberg B, Holst G, Rennemark M, Sjolund BM, Thorslund M, Wiberg I, Winblad B, Wimo A. A longitudinal study integrating population, care and social services data. The Swedish National study on Aging and Care (SNAC). Aging Clin Exp Res. 2004;16:158–68. Lagergren M, Fratiglioni L, Hallberg IR, Berglund J, Elmstahl S, Hagberg B, Holst G, Rennemark M, Sjolund BM, Thorslund M, Wiberg I, Winblad B, Wimo A. A longitudinal study integrating population, care and social services data. The Swedish National study on Aging and Care (SNAC). Aging Clin Exp Res. 2004;16:158–68.
17.
go back to reference American Psychiatric Association AP. Diagnostic and statistical manual of mental disorders, 3rd edn revised (DSM-IIIR). Washington DC: American Psychiatric Association; 1987. American Psychiatric Association AP. Diagnostic and statistical manual of mental disorders, 3rd edn revised (DSM-IIIR). Washington DC: American Psychiatric Association; 1987.
18.
go back to reference WHO. WHO Collaborating Centre for Drug Statistics Methodology. Oslo: WHO. Accessed 20131119. WHO. WHO Collaborating Centre for Drug Statistics Methodology. Oslo: WHO. Accessed 20131119.
19.
go back to reference Charlson ME, Pompei P, Ates K, et al. A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. J Chronic Dis. 1987;40:373–83.PubMedCrossRef Charlson ME, Pompei P, Ates K, et al. A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. J Chronic Dis. 1987;40:373–83.PubMedCrossRef
20.
go back to reference Klarin I, Wimo A, Fastbom J. The association of inappropriate drug use with hospitalisation and mortality : a population-based study of the very old. Drugs Aging. 2005;22:69–82.PubMedCrossRef Klarin I, Wimo A, Fastbom J. The association of inappropriate drug use with hospitalisation and mortality : a population-based study of the very old. Drugs Aging. 2005;22:69–82.PubMedCrossRef
21.
go back to reference Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron. 1976;16:31–41.PubMedCrossRef Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron. 1976;16:31–41.PubMedCrossRef
22.
go back to reference Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. Studies of illness in the aged. The index of ADL: A standardized measure of biological and psychosocial function. JAMA. 1963;185:914–9.PubMedCrossRef Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. Studies of illness in the aged. The index of ADL: A standardized measure of biological and psychosocial function. JAMA. 1963;185:914–9.PubMedCrossRef
23.
go back to reference Dunn G, Mirandola M, Amaddeo F, Tansella M. Describing, explaining or predicting mental health care costs: a guide to regression models. Methodological review. Br J Psychiatry. 2003;183:398–404.PubMedCrossRef Dunn G, Mirandola M, Amaddeo F, Tansella M. Describing, explaining or predicting mental health care costs: a guide to regression models. Methodological review. Br J Psychiatry. 2003;183:398–404.PubMedCrossRef
24.
go back to reference Jensen-Dahm C, Gasse C, Astrup A, Mortensen PB, Waldemar G. Frequent use of opioids in patients with dementia and nursing home residents-A study of the entire elderly population of Denmark. Alzheimers Dement. 2014; (1552–5279 (Epub ahead of print)). Jensen-Dahm C, Gasse C, Astrup A, Mortensen PB, Waldemar G. Frequent use of opioids in patients with dementia and nursing home residents-A study of the entire elderly population of Denmark. Alzheimers Dement. 2014; (1552–5279 (Epub ahead of print)).
25.
go back to reference Haider SI, Johnell K, Thorslund M, Fastbom J. Trends in polypharmacy and potential drug-drug interactions across educational groups in elderly patients in Sweden for the period 1992–2002. Int J Clin Pharmacol Ther. 2007;45:643–53.PubMedCrossRef Haider SI, Johnell K, Thorslund M, Fastbom J. Trends in polypharmacy and potential drug-drug interactions across educational groups in elderly patients in Sweden for the period 1992–2002. Int J Clin Pharmacol Ther. 2007;45:643–53.PubMedCrossRef
26.
go back to reference Jyrkka J, Vartiainen L, Hartikainen S, Sulkava R, Enlund H. Increasing use of medicines in elderly persons: a five-year follow-up of the Kuopio 75 + Study. Eur J Clin Pharmacol. 2006;62:151–8.PubMedCrossRef Jyrkka J, Vartiainen L, Hartikainen S, Sulkava R, Enlund H. Increasing use of medicines in elderly persons: a five-year follow-up of the Kuopio 75 + Study. Eur J Clin Pharmacol. 2006;62:151–8.PubMedCrossRef
27.
go back to reference Theodorou AA, Johnson KM, Moore M, Ruf S, Wade T, Szychowski JA. Drug utilization patterns in patients with Alzheimer’s disease. The American Journal of Pharmacy Benefits. New Jersey: Managed Care & Healthcare Communications; 2010. Theodorou AA, Johnson KM, Moore M, Ruf S, Wade T, Szychowski JA. Drug utilization patterns in patients with Alzheimer’s disease. The American Journal of Pharmacy Benefits. New Jersey: Managed Care & Healthcare Communications; 2010.
28.
go back to reference Giron MS, Forsell Y, Bernsten C, Thorslund M, Winblad B, Fastbom J. Psychotropic drug use in elderly people with and without dementia. Int J Geriatr Psychiatry. 2001;16:900–6.PubMedCrossRef Giron MS, Forsell Y, Bernsten C, Thorslund M, Winblad B, Fastbom J. Psychotropic drug use in elderly people with and without dementia. Int J Geriatr Psychiatry. 2001;16:900–6.PubMedCrossRef
29.
go back to reference Hosia-Randell H, Pitkala K. Use of psychotropic drugs in elderly nursing home residents with and without dementia in Helsinki, Finland. Drugs Aging. 2005;22:793–800.PubMedCrossRef Hosia-Randell H, Pitkala K. Use of psychotropic drugs in elderly nursing home residents with and without dementia in Helsinki, Finland. Drugs Aging. 2005;22:793–800.PubMedCrossRef
30.
go back to reference Gustafsson M, Karlsson S, Gustafson Y, Lovheim H. Psychotropic drug use among people with dementia -- a six-month follow-up study. BMC Pharmacol Toxicol. 2013;14:56.PubMedCentralPubMedCrossRef Gustafsson M, Karlsson S, Gustafson Y, Lovheim H. Psychotropic drug use among people with dementia -- a six-month follow-up study. BMC Pharmacol Toxicol. 2013;14:56.PubMedCentralPubMedCrossRef
31.
go back to reference Richter T, Mann E, Meyer G, Haastert B, Kopke S. Prevalence of Psychotropic Medication Use among German and Austrian Nursing Home Residents: A Comparison of 3 Cohorts. J Am Med Dir Assoc. 2012;13:187. e187-187 e113.PubMedCrossRef Richter T, Mann E, Meyer G, Haastert B, Kopke S. Prevalence of Psychotropic Medication Use among German and Austrian Nursing Home Residents: A Comparison of 3 Cohorts. J Am Med Dir Assoc. 2012;13:187. e187-187 e113.PubMedCrossRef
32.
go back to reference Guthrie B, Clark SA, Reynish EL, McCowan C, Morales DR. Differential impact of two risk communications on antipsychotic prescribing to people with dementia in Scotland: segmented regression time series analysis 2001–2011. PLoS One. 2013;8:e68976.PubMedCentralPubMedCrossRef Guthrie B, Clark SA, Reynish EL, McCowan C, Morales DR. Differential impact of two risk communications on antipsychotic prescribing to people with dementia in Scotland: segmented regression time series analysis 2001–2011. PLoS One. 2013;8:e68976.PubMedCentralPubMedCrossRef
33.
go back to reference Johnell K, Religa D, Eriksdotter M. Differences in drug therapy between dementia disorders in the Swedish dementia registry: a nationwide study of over 7,000 patients. Dement Geriatr Cogn Disord. 2013;35:239–48.PubMedCrossRef Johnell K, Religa D, Eriksdotter M. Differences in drug therapy between dementia disorders in the Swedish dementia registry: a nationwide study of over 7,000 patients. Dement Geriatr Cogn Disord. 2013;35:239–48.PubMedCrossRef
34.
go back to reference Qiu C, von Strauss E, Backman L, Winblad B, Fratiglioni L. Twenty-year changes in dementia occurrence suggest decreasing incidence in central Stockholm, Sweden. Neurology. 2013;80:1888–94.PubMedCrossRef Qiu C, von Strauss E, Backman L, Winblad B, Fratiglioni L. Twenty-year changes in dementia occurrence suggest decreasing incidence in central Stockholm, Sweden. Neurology. 2013;80:1888–94.PubMedCrossRef
35.
go back to reference Wimo A, Johansson L, Jönsson L. The societal costs of dementia and the number of demented in Sweden 2005 (in Swedish). Underlag från experter, eds. Stockholm: Socialstyrelsen; 2007. Wimo A, Johansson L, Jönsson L. The societal costs of dementia and the number of demented in Sweden 2005 (in Swedish). Underlag från experter, eds. Stockholm: Socialstyrelsen; 2007.
36.
go back to reference Salloway S, Mintzer J, Weiner MF, Cummings JL. Disease-modifying therapies in Alzheimer’s disease. Alzheimers Dement. 2008;4:65–79.PubMedCrossRef Salloway S, Mintzer J, Weiner MF, Cummings JL. Disease-modifying therapies in Alzheimer’s disease. Alzheimers Dement. 2008;4:65–79.PubMedCrossRef
37.
go back to reference Hosia-Randell H, Suominen M, Muurinen S, Pitkala KH. Use of laxatives among older nursing home residents in Helsinki, Finland. Drugs Aging. 2007;24:147–54.PubMedCrossRef Hosia-Randell H, Suominen M, Muurinen S, Pitkala KH. Use of laxatives among older nursing home residents in Helsinki, Finland. Drugs Aging. 2007;24:147–54.PubMedCrossRef
38.
go back to reference Wastesson JW, Parker MG, Fastbom J, Thorslund M, Johnell K. Drug use in centenarians compared with nonagenarians and octogenarians in Sweden: a nationwide register-based study. Age Ageing. 2012;41:218–24.PubMedCrossRef Wastesson JW, Parker MG, Fastbom J, Thorslund M, Johnell K. Drug use in centenarians compared with nonagenarians and octogenarians in Sweden: a nationwide register-based study. Age Ageing. 2012;41:218–24.PubMedCrossRef
Metadata
Title
The impact of dementia on drug costs in older people: results from the SNAC study
Authors
Anders Sköldunger
Johan Fastbom
Anders Wimo
Laura Fratiglioni
Kristina Johnell
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2016
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-016-0547-x

Other articles of this Issue 1/2016

BMC Neurology 1/2016 Go to the issue