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A 50% drop in ten years for reimbursed anti-dementia drugs

In 2022, 1.2% of people aged 65 and over in Belgium have used an anti-dementia medication at least once. Over the past ten years, reimbursed use of these drugs has fallen by half. These figures come from the Intermutualist Agency (AIM).

In 2019, dementia, together with coronary heart disease, was the leading cause of death in Belgium, each accounting for 9% of all deaths. The number of Belgians suffering from dementia is estimated at 200,000, or 8.5% of those aged 65 and over. The prevalence of dementia generally increases with age, and the aging of the population is expected to increase this percentage further.

Current treatments aim to combat symptoms and preserve the quality of life of patients and their caregivers for as long as possible. Anti-dementia drugs (N06D) allow, in certain forms of dementia, a modest stabilization of cognitive functions in patients with mild or moderate forms. However, their effect is limited in time, and the benefit/risk ratio is debated. In 2011, the reimbursement of certain antidementia medications was restricted due to their effectiveness being deemed insufficient.

In 2022, 1.2% of those aged 65 and over have used an anti-dementia medication at least once. Compared to ten years ago, reimbursed usage has been reduced by half. In Flanders, this usage is more than twice as high as that in Wallonia and Brussels, while in 2011, the figures were much closer. Likewise, the volume of use is more than twice as high in Flanders. Among those aged 65 and over who spent at least one day in a nursing home in 2022, 4.2% received anti-dementia medication, a sharply reduced percentage compared to 2011, when it reached 11.1%. This overall drop in reimbursed usage is mainly attributable to this group. Among patients who received home care at least once in 2022 (without staying in a nursing home), 3.5% take anti-dementia medications, which also represents a clear decrease. Among those aged 65 and over who have not received long-term nursing care, the use of these medications has decreased slightly over the last decade, from 1% to 0.7%.

More frequent use among women

The use of antidementia medications is higher among women (1.3%) than among men (1.0%), although this gap has decreased over ten years. According to Sciensano data, dementia has become the leading cause of death among women since 2013. This phenomenon is mainly explained by the higher life expectancy of women. As age is a significant risk factor for dementia, women are over-represented in the 80 and over category. However, a specific analysis among long-term care users makes this gap disappear.

Nearly nine out of ten patients who have received a prescription for an anti-dementia medication use them for a long time (more than a year), 5% use them for six to twelve months, and the remaining 7% for less than six months. . The latter include not only patients whose treatment is stopped, but also those who die.

> Read the AIM report

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