Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski, Gospodin Iliev
ISSN: 1312 773X (Online)
Issue: 2016, vol. 22, issue 3
Subject Area: Medicine
Pages: 1238-1241
DOI: 10.5272/jimab.2016223.1238
Published online: 30 July 2016

J of IMAB 2016 Jul-Sep;22(3):1238-1241
Mariana Arnaoudova1 Corresponding Autor, Anna Todorova2, Antoaneta Tsvetkova3
1) Department of psychiatry and medical psychology, Medical University, Varna, Bulgaria
2) Faculty of Pharmacy, Medical University, Varna, Bulgaria
3) Medical College, Medical University, Varna, Bulgaria.

Background: Alzheimer's disease (AD) is a progressive neurodegenerative disorder and presents a great burden for the person, family and society as a whole. Since 2012, in Bulgaria, AD is accepted as a disorder of a great socio-economic significance and the drugs for home treatment are included in the reimbursement list of the National Health Insurance Fund (NHIF).
Objective: To trace the access to treatment of Alzheimer’s in-home patients, as a result of generic substitution on the base of share distribution of the original and generic products.
Methods:  We collected data for the sales of pharmaceutical products (PP’s), containing donepezil hydrochloride and memantine hydrochloride from a distributor for the Northeast region of Bulgaria (Varna) in the period 2014-2015. An analysis of the percentage share distribution of the original and generic products was conducted.
Results:  According to our results original product Aricept accounts for only 4%, while the market share for its generics is 96%. In this group the share to be paid from NHIF is 25%, the remaining 75% from the cost is paid by the patients. The original product Axura occupies 8% market share, the generics- 92%. In this group the share to be paid from NHIF is 50% for generics, while Axura was removed from the Positive reimbursement list. We comment the significant differences in the sale shares in several directions.
Conclusion: The reduction of expenses, with the use of generics, would help more patients to receive an optimal treatment and the savings could be redirected for other costly treatments.

Key words: Alzheimer’s disease, cholinesterase inhibitors, memantine, financial costs, generics,

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Please cite this article in PubMed Style or AMA (American Medical Association) Style:
Arnaoudova M, Todorova A, Tsvetkova A. Financial availability of in-home medical treatment of patients with Alzheimer’s disease. J of IMAB. 2016 Jul-Sep;22(3):1238-1241.

Correspondence to: Assoc. prof. Mariana Arnaoudova, MD, PhD, Department of psychiatry and medical psychology, Medical University, Varna; 55, Marin Drinov str. 9002 Varna, Bulgaria; E-mail:

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Received: 19 May 2016
Published online: 30 July 2016

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