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The Availability of Antidementia Drugs in Europe
Table 1: Authorisation and Reimbursement of Alzheimer Table 2: Prescription and Reimbursement Criteria for
Drugs in Europe Treatments of Alzheimer’s Disease in Europe
Country Donepezil Rivastigmine Galantamine Memantine Country Initial Continuing Special Upper Upper
AR A R A R AR Treatment Treatment Examinations and Lower and Lower
Austria Yes Yes Yes Yes Yes Yes Yes Yes Decision Decision Required MMSE MMSE
Belgium Yes Yes Yes Yes Yes Yes Yes Yes Scores Scores
Bulgaria Yes No Yes No Yes No No No (AchI)
9
(Memantine)
10
Cyprus Yes Yes Yes Yes Yes Yes Yes Yes Austria Specialist Specialist MMSE 26–10 14–3
Czech Republic Yes Yes Yes Yes Yes Yes Yes Yes doctors doctors
Denmark Yes Yes Yes Yes Yes Yes Yes Yes Belgium Specialist Specialist Diagnostic >10 15–0
Estonia Yes Yes Yes No Yes Yes Yes Yes doctors doctors protocol
Finland Yes Yes Yes Yes Yes Yes Yes Yes Bulgaria No reimbursement
France Yes Yes Yes Yes Yes Yes Yes Yes Cyprus No information
Germany Yes Yes Yes Yes Yes Yes Yes Yes Czech Specialist Specialist MMSE 20–13 16–6
Greece Yes Yes Yes Yes Yes Yes Yes Yes Republic doctors doctors
Hungary Yes Yes Yes Yes No No Yes Yes Denmark No No Diagnostic None None
Iceland Yes Yes Yes Yes Yes Yes Yes Yes restrictions
11
restrictions protocol
Ireland Yes Yes Yes Yes Yes Yes Yes Yes Estonia No information
Italy Yes Yes Yes Yes Yes Yes Yes No Finland No No None None None
Latvia Yes No Yes No Yes No Yes No restrictions
12
restrictions
Lithuania Yes Yes No No Yes No Yes Yes France Specialist No None 26–10 15–0
Luxembourg Yes Yes Yes Yes Yes Yes Yes Yes doctors restrictions
Malta Yes No Yes No Yes No Yes No Germany No No None None None
The Netherlands No No Yes Yes Yes Yes Yes Yes restrictions restrictions
Norway Yes Yes Yes Yes Yes Yes Yes No Greece Specialist No None None None
Poland Yes Yes
5
Yes Yes Yes No Yes No doctors restrictions
Portugal Yes Yes Yes Yes Yes Yes Yes Yes Hungary Specialist Specialist Diagnostic 26–10 18–0
Romania Yes Yes Yes Yes No No Yes Yes doctors doctors protocol
Slovak Republic Yes Yes Yes Yes Yes Yes Yes Yes Iceland No No Diagnostic None None
Slovenia Yes Yes Yes Yes Yes Yes Yes Yes restrictions
13
restrictions protocol
Spain Yes Yes Yes Yes Yes Yes Yes Yes Ireland No No None None None
Sweden Yes Yes Yes Yes Yes Yes Yes Yes restrictions restrictions
Switzerland Yes Yes Yes Yes Yes Yes Yes Yes Italy Alzheimer Alzheimer Diagnostic 26–10 n/a
Turkey Yes Yes Yes Yes Yes Yes Yes Yes evaluation evaluation protocol
United Kingdom Yes Yes Yes Yes Yes Yes Yes No
6
unit unit
Latvia No information
A = authorised; R = part of the reimbursement system.
Lithuania MMSE None 20–0
Luxembourg No No Diagnostic 26–10 15–0
survey of its members to highlight any inequalities within the EU with
restrictions restrictions protocol
regard to the access of people with Alzheimer’s disease to existing
Malta No reimbursement
The Specialist Specialist Diagnostic 26–10 14–3
treatments. In its survey, Alzheimer Europe concentrated on finding
Netherlands doctors doctors protocol
out which of the available treatments were reimbursed under national
Norway No No MMSE >12 N/A
health systems in different European countries, but also aimed at
restrictions
14
restrictions
quantifying the delays experienced by different countries in granting Poland No No MMSE 26–10 N/A
such reimbursement, as well as any other access restrictions imposed restrictions restrictions
by national health systems for the reimbursement of these medicines.
Portugal Specialist Specialist None None None
doctors doctors
Romania Specialist Specialist Diagnostic >12 >12
The Reimbursement of Alzheimer Treatments in Europe
doctors doctors protocol
Reimbursement systems in Europe vary quite considerably, but
Slovak Specialist Specialist MMSE 24–13 24–13
each European country has a system in place that guarantees that
Republic doctors doctors
essential medicines are made available to patients at an affordable
Slovenia Specialist No MMSE 26–10
15
26–10
price that is at least partly underwritten by the national health systems. doctors restrictions
Table 1 shows whether the four drugs available for the treatment of
Spain Specialist Specialist MMSE None None
Alzheimer’s disease have been authorised nd whether they are part of
doctors doctors
the reimbursement system of the respective countries. However, there
Sweden No No None None None
restrictions restrictions
is no indication as to the level of reimbursement provided or the access
Switzerland No No MMSE >10 >3
restrictions imposed by the reimbursement systems.
restrictions restrictions
Turkey Specialist No None None None
As can be seen from Table 1, with the exception of Bulgaria, Latvia and doctors restrictions
Malta, one or more AchIs are reimbursed in all the European countries
United Specialist No MMSE 30–12 N/A
covered by the Alzheimer Europe survey, even if there may be slight
Kingdom doctors restrictions
16
variations as to which of the medicines are available and reimbursed.
EUROPEAN NEUROLOGICAL DISEASE 2007 41
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