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 Box 8.1).
Box 8.1: Dementia-specific medications
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 (Drug Utilisation Sub-Committee 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.
Donepezil, Galantamine and Rivastigmine are approved in Australia for the treatment of mild to moderate Alzheimer’s disease (Drug Utilisation Sub-Committee 2016). They are acetylcholinesterase inhibitors and 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 2020). 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 is approved in Australia for the treatment of moderately severe to severe Alzheimer’s disease (Drug Utilisation Sub-Committee 2016). It 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 2020).
The following pages focus 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. 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.
It is important to note that information on medication intake and adherence to medication plans is not available. The data presented here relate only to prescriptions dispensed. In addition, the PBS and RPBS do not contain data on dispensing of privately prescribed medications (prescriptions that are not eligible for subsidy under the PBS or RPBS), medications to public hospital in-patients and over-the-counter medications.
Refer to the Prescription data tables for the underlying data presented in these pages.
Over 623,300 prescriptions were dispensed for dementia-specific medications in 2019–20
In 2019–20, there were over 623,300 prescriptions dispensed for dementia-specific medications to just under 64,600 Australians with dementia aged 30 and over (Figure 8.1). This is equivalent to 9.7 scripts per person who was dispensed a script for a dementia-specific medication in 2019–20. Each script is usually for a month’s supply of medicine.
Among those who were dispensed scripts for dementia-specific medications in 2019–20:
- 42% were men (27,400 men) and 58% were women (37,100 women).
- 1 in 3 people were aged 85 or over.
- Women were dispensed a greater number of scripts and were about the same age (361,600 scripts and average age of 81) as men (261,200 scripts and average age of 80).
- On average, men were dispensed 9.5 scripts per person and women were dispensed 9.7 scripts per person.
- Older people were dispensed more scripts on average – increasing from 8.3 scripts per person among those aged under 65 to 10.3 scripts per person among those aged 85 and over.