Prescriptions for dementia-specific medications
While there is currently no known cure for dementia, there are 4 medications available under the Pharmaceutical Benefits Scheme (PBS) and Repatriation Pharmaceutical Benefits Scheme (RPBS, available for eligible veterans, war widows/widowers and their dependants) that may assist in managing dementia symptoms and slow dementia progression. In Australia, these medications are currently only subsidised for people with a diagnosis of Alzheimer’s disease (see Dementia-specific medications).
This page focuses on dispensing patterns of dementia-specific medications supplied under the PBS and RPBS, as well as a profile of the people who were dispensed scripts for these medicines.
See also, Antipsychotics and other medications dispensed to people with dementia.
There are 4 dementia-specific medications – Donepezil, Galantamine, Rivastigmine and Memantine – currently subsidised under the PBS and RPBS. These medications can be prescribed to patients with a confirmed diagnosis of Alzheimer’s disease made by (or in consultation with) a specialist or consultant physician under specific clinical criteria (DUSC 2016). In order to continue treatment, patients must demonstrate a clinically meaningful response to the treatment. This may include improvements in the patients’ quality of life, cognitive function and/or behavioural symptoms.
The Therapeutic Goods Administration (TGA) note the following therapeutic indications for each drug:
- Donepezil: indicated for the treatment of mild, moderate and severe Alzheimer’s disease.
- Galantamine: indicated for the treatment of mild to moderately severe Alzheimer’s disease.
- Rivastigmine: indicated for the treatment of patients with mild to moderately severe Alzheimer’s disease (as hydrogen tartrate), or mild, moderate and severe Alzheimer’s disease (as EXELON patch).
- Memantine: indicated for the treatment of moderately severe to severe Alzheimer’s disease
Three of the medications (Donepezil, Galantamine and Rivastigmine) are acetylcholinesterase inhibitors. These types of medications work by blocking the actions of the enzyme acetylcholinesterase, which destroys acetylcholine – a major neurotransmitter for memory. The use of these medicines may lead to increased communication between nerve cells and slow dementia progression (Dementia Australia 2024a). Research suggests that these medicines may also benefit people with Lewy body dementia and dementia associated with Parkinson's disease (Noufi et al. 2019), however, these medications are not subsidised in Australia for treating these types of dementia.
Memantine works by blocking the neurotransmitter glutamate, which causes damage to brain cells and is present in high levels in people with Alzheimer’s disease (Dementia Australia 2024a).
In May 2025, the TGA approved the use of Donanemab for Australians with mild cognitive impairment due to Alzheimer’s disease, or early symptomatic Alzheimer’s disease (TGA 2025a). Donanemab has been demonstrated to slow cognitive and functional decline and works by inducing antibodies that attach to and remove amyloid plaques from the brain. It is not approved for people with two copies of the ApoE ε4 gene due to increased risk of side effects, and people who take Donanemab require regular MRI scans to monitor side effects and treatment efficacy. In July 2025 the Pharmaceutical Benefits Advisory Committee did not recommend listing Donanemab on the PBS due to the modest clinical impact and high burden of treatment on patients and the health system (PBS 2025).
In October 2024, the TGA chose to not register lecanemab (LEQEMBI) for patients with mild Alzheimer's disease due to safety concerns for people with one or two copies of the ApoE ε4 gene (TGA 2025b).
The statistics presented here are derived from the Pharmaceutical Benefits Scheme.
As dementia is a condition that primarily affects older people, analyses were limited to prescriptions dispensed to people aged 30 and over. This age limit is consistent with the lower age limit of dementia prevalence estimates for Australia.
Refer to the Technical notes for further information on the Pharmaceutical Benefits Scheme, the codes used to identify dementia-specific medications and the calculation of defined daily doses.
The data presented here relate only to prescriptions dispensed under the PBS and RPBS. The dispensing of prescriptions not eligible for subsidy under the PBS and RPBS, like privately prescribed medications, medications to public hospital in-patients and over-the-counter medications, are not included in the data. Drugs distributed by the government’s Remote Area Aboriginal Health Services (RAAHS) program are also not included here.
This page will be updated to include any future medications that become approved for use and included in the PBS.
Scripts dispensed for dementia-specific medications in 2023–24
In 2023–24, there were nearly 737,000 prescriptions dispensed for dementia-specific medications to about 77,500 Australians with dementia aged 30 and over (Figure 8.1). This is equivalent to 9.5 scripts per person who was dispensed a script for a dementia-specific medication in 2023–24. Each script is usually for a month’s supply of medicine.
Among those who were dispensed scripts for dementia-specific medications in 2023–24:
- 43% were men (33,400 men) and 57% were women (44,100 women)
- 1 in 3 people were aged 85 or over
- on average, men were dispensed 9.4 scripts per person and women were dispensed 9.6 scripts per person
- older people were dispensed more scripts on average – increasing from 8.7 scripts per person among those aged 30–64 to 9.6 scripts per person among those aged 85 and over.
There was an 11% increase in the age-standardised rate of scripts dispensed for dementia-specific medications to Australians aged 30 and over between 2014–15 and 2023–24. There was a greater increase in the age-standardised rate of scripts dispensed to men (13%) than women (10%). The number of people dispensed scripts for dementia-specific medications increased by 46% from around 53,100 people in 2014–15 to around 77,500 people in 2023–24 (Figure 8.2, Table S8.2).
Figure 8.1: People who were dispensed scripts for dementia-specific medications: number by age and sex in 2023–24
The bar chart shows a steady increase in the number of people dispensed scripts for dementia-specific medications in both men and women with increasing age.
Figure 8.2: People and scripts dispensed for dementia-specific medications: number, crude and age-standardised rate by sex between 2013–14 and 2023–24
This line graph shows that each year, women have a higher crude and age-standardised rate of scripts dispensed than men.
Most commonly dispensed dementia-specific medications
Donepezil was the most commonly dispensed dementia-specific medication in 2023–24 for men and women, accounting for just over 484,000 prescriptions or 66% of all scripts dispensed for dementia-specific medications. Each of the other dementia-specific medications (Rivastigmine, Memantine and Galantamine) accounted for between 9–14% of all scripts dispensed (Figure 8.3). After Donepezil, Memantine was the second-most dispensed script for women and for men aged over 80. For men aged 30 to 79 Rivastigmine was the second-most dispensed medication (Table S8.3).
Figure 8.3: Percentage of all scripts for dementia-specific medications dispensed: by medication type and sex in 2023–24
This bar charts shows how the proportion of scripts for dementia-specific medications dispensed by medication type slightly differ for men and women.
| Sex | Donepezil | Galantamine | Memantine | Rivastigmine |
|---|---|---|---|---|
| Men | 64.4% | 9.1% | 13.2% | 13.3% |
| Women | 66.7% | 9.0% | 14.0% | 10.3% |
| Persons | 65.7% | 9.0% | 13.7% | 11.6% |
Source:
AIHW analysis of PBS data maintained by the Australian Government Department of Health, Disability and Ageing
Differences by state and territories
The number of people who were dispensed scripts for dementia-specific medications per 1,000 people varied by state and territory in 2023–24 but was consistently higher among women than men in each state and territory. In Australia overall, there were 4.6 people dispensed scripts for dementia-specific medications per 1,000 people (Table S8.4).
The rates of men and women who were dispensed scripts for dementia-specific medications were lowest in the Northern Territory and highest in South Australia (Figure 8.4). This may relate to differences in access to specialists who initially prescribe the medication (AIHW 2023), but it is important to note that drugs distributed by the government’s Remote Area Aboriginal Health Services (RAAHS) program are not included in PBS data. This may be a factor in the Northern Territory’s low dispensing rates.
Figure 8.4: People who were dispensed scripts for dementia-specific medications: crude rate by sex and state/territory in 2023–24
This bar chart shows that Northern Territory, Western Australia and Tasmania had the lowest crude rate of scripts dispensed, while New South Wales, the Australian Capital Territory and South Australia had the highest.
Dispensing of dementia-specific medications for the first time
In 2023–24, just over 20,700 people were dispensed scripts for dementia-specific medications for the first time (Table S8.5). Most people (29%) were initiated on Donepezil (Table S8.6). Among those who were initiated on a dementia-specific medication in 2023–24, 44% were men (9,100 men) and 56% were women (11,600 women).
There was a 49% increase in the number of people dispensed dementia-specific medications for the first time between 2014–15 and 2023–24 (Figure 8.5). However, after adjusting for changes in Australia's population age structure over time, rates remained relatively stable over the last 10 years, suggesting that the number of people dispensed dementia-specific medications for the first time has risen mostly due to the ageing population of Australia.
Figure 8.5: Number of people who were dispensed dementia-specific medications for the first time between 2014–15 and 2023–24
The line graph shows that women and men were dispensed more dementia-specific medication each year. However, the crude and age-standardised rates of people dispensed dementia-specific medications for the first time which takes into account population age structures (shown in data Table S8.5), has remained relatively stable over the last 10 years.
| Year | Men | Women | Persons |
|---|---|---|---|
| 2014–15 | 5,940 | 7,959 | 13,899 |
| 2015–16 | 6,243 | 8,213 | 14,456 |
| 2016–17 | 6,923 | 8,865 | 15,788 |
| 2017–18 | 7,003 | 8,882 | 15,885 |
| 2018–19 | 6,928 | 8,784 | 15,712 |
| 2019–20 | 6,815 | 8,600 | 15,415 |
| 2020–21 | 7,236 | 8,888 | 16,124 |
| 2021–22 | 7,206 | 9,204 | 16,410 |
| 2022–23 | 8,427 | 10,230 | 18,657 |
| 2023–24 | 9,146 | 11,563 | 20,709 |
Source:
AIHW analysis of PBS data maintained by the Australian Government Department of Health, Disability and Ageing
Who prescribes scripts for initial and continuing doses of dementia-specific medications?
In 2023–24, general practitioners (GPs) prescribed 47% of initial scripts of dementia-specific medications and 84% of continuing scripts (Table S8.13). It should be noted that for GPs to prescribe initial subsidised scripts for dementia-specific medication, they must first confirm an Alzheimer’s disease diagnosis with a specialist medical practitioner (Dementia Australia 2024b). Specialists in geriatrics were the second most common prescribers of dementia-specific medications for both initial and continuing scripts (38% and 9%, respectively), followed by neurologists (6.2% and 1.8%, respectively).
Defined daily dose dispensed for dementia-specific medications
It is important to note that dispensing patterns of dementia-specific medications do not provide information on medication intake and adherence to medications plans. The “defined daily dose” is another method used for estimating drug consumption (see Box 8.1).
Box 8.1: What are defined daily doses?
Variations between medicines (for example, pack size and drug strength) can limit comparisons of drug consumption over time and between regions and populations. To address this, the World Health Organization created the technical unit of measurement, the Defined Daily Dose (DDD) to provide a rough estimate of drug consumption (WHO n.d.).
A defined daily dose is a measure that represents the dose of a particular drug that is assumed to be the ‘average amount per day’ when used by adults. However, DDDs may not match the recommended or prescribed dose and may underestimate or overestimate ‘true’ use (WHO n.d.). For more information on how the number of DDDs are calculated in this report, refer to the Technical notes.
In 2023–24, 22 million defined daily doses were dispensed for dementia-specific medications, at a rate of 3.6 DDDs per 1,000 population per day (Table S8.7). Donepezil had the highest rates of dispensed DDDs (2.5 DDDs per 1,000 population per day) while each of the other dementia-specific medications (Rivastigmine, Memantine and Galantamine) had a dispensing rate ranging from 0.3–0.5 DDDs per 1,000 population per day.
Between 2014–15 and 2023–24, the total rate of DDDs dispensed for dementia-specific medications increased from 2.9 to 3.6 DDDs per 1,000 population per day. The rate of Donepezil dispensed increased slightly from 2 to 2.5 DDDs per 1,000 population per day. The rate of dispensing for Rivastigmine and Memantine also increased slightly, while Galantamine slightly decreased (from 0.5 to 0.3 DDDs per 1,000 population per day, Figure 8.6)
Figure 8.6: Defined daily dose: number and rate by dementia-specific medications between 2013–14 to 2023–24
The line graph shows how the number of Donepezil, Memantine and Rivastigmine DDDs have increased since 2013–14, while number of Galantamine DDDs have decreased.
AIHW (Australian Institute of Health and Welfare) (2023) Geographical variation in health service use by people living with dementia, AIHW, Australian Government, accessed 11 April 2024.
Dementia Australia (2024a) Treatment and management of dementia, Dementia Australia website, accessed 26 June 2024.
Dementia Australia (2024b) Testing and Diagnosis, Dementia Australia website, accessed 26 June 2024.
DUSC (Drug Utilisation Sub-Committee) (2016) Medicines for Alzheimer disease, Department of Health and Aged Care, Australian Government, accessed 10 July 2023.
Noufi P, Khoury R, Jeyakumar S and Grossman GT (2019) Use of Cholinesterase Inhibitors in Non-Alzheimer’s Dementias, Drugs & Aging, 36:719–731, doi:10.1007/s40266-019-00685-6.
PBS (Pharmaceutical Benefits Scheme) (2025) Recommendations made by the PBAC – July 2025, Department of Health, Disability and Ageing, accessed 22/08/2025.
TGA (Therapeutic Goods Administration) (2025a) KISUNLA donanemab 350 mg/20 mL concentrated solution for intravenous infusion vial (420194), Department of Health, Disability and Ageing, accessed 7 July 2025.
TGA (Therapeutic Goods Administration) (2025b) TGA confirms decision to not register lecanemab (LEQEMBI), Department of Health, Disability and Ageing, accessed 7 July 2025.
WHO (World Health Organization) (n.d.) Defined Daily Dose (DDD) , WHO website, accessed 26 June 2024.