Real-world analysis of medication adherence and cost of care for comorbid conditions in patients with early Alzheimer’s disease in the U.S.

To understand medication adherence and associated healthcare costs of patients with early Alzheimer’s disease (AD). This retrospective cohort study used the Axon Registry® linked with claims data to examine medication adherence of U.S. patients with early AD (mild cognitive impairment [MCI] and mild dementia due to AD) from 2015 to 2022. Medication adherence was quantified by the proportion of days covered (PDC) over a one-year follow-up, and adherence rate was defined at a PDC ≥ 80%. Patient comorbidities and healthcare costs were described. Of 333 patients included, 213 (64%) were female with a median (IQR) age 79 (72–83) years. Patients had a mean (SD) of 2.3 (2.1) comorbidities and took a mean (SD) of 3.0 (1.5) medications. Weighted-average PDC across medications was 74.4% with 7 out of 10 medication classes having a medication adherence rate lower than 60%. DPP-4 inhibitors had the highest medication adherence rate (66.67% of patients), and memantine had the lowest (39.13% of patients). Annual median (IQR) medical and pharmacy costs per-patient were $5,268 ($1,808–$14,651) and $658 ($187–$2,736), respectively. Patients with early AD had multiple comorbidities and took multiple medications. Suboptimal medication adherence and high healthcare costs were observed. This study looked at people in the early stage of their Alzheimer’s disease in the U.S. to understand the extent to which they were taking their medications. It also explored what other health problems those patients had, which medications they took, how often they took their medicine, and how much their healthcare costs were. Patients were chosen based on their scores on a cognitive assessment. Information about their health problems and medications was obtained from their health records. The study found that most patients had many other health issues in addition to Alzheimer’s disease. For these health issues, they were given many different medications. The study found that these patients did not take their medications as regularly as they were supposed to. The costs of medications and medical care were high for these patients. The study suggests that when prescribing medications for people with early Alzheimer’s disease, it is important to consider the comorbidities and manage the associated medication burden.