1. Off-Label Use of Antipsychotic Agents in Dementia: Evidence for the Revision of the Reimbursement Policy
- Author
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Rimas Jonas Jankūnas, Vita Lesauskaitė, Donatas Stakišaitis, and Kristina Zamarytė-Sakavičienė
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Pharmacy ,Legislation ,Accounting ,Marketing authorization ,Off-label use ,030226 pharmacology & pharmacy ,01 natural sciences ,010104 statistics & probability ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Dementia ,Humans ,Pharmacology (medical) ,European Union ,0101 mathematics ,Antipsychotic ,Pharmacology, Toxicology and Pharmaceutics (miscellaneous) ,Reimbursement ,business.industry ,Public health ,Public Health, Environmental and Occupational Health ,Off-Label Use ,medicine.disease ,Trihexyphenidyl ,Insurance, Health, Reimbursement ,Haloperidol ,business ,Antipsychotic Agents - Abstract
Harmonized requirements apply for the marketing authorization of medicinal products in the EU Member States. On the contrary, the national legislations on the drug reimbursement are not harmonized. The aim of this study was to find out if they are robust enough to ensure high standards of public health protection with focus on the symptomatic treatment of dementia in the elderly. A computerized search of authorized therapeutic indications of haloperidol and trihexyphenidyl in the national databases of 8 EU member states and an analysis of the national legislation on reimbursement policies in Lithuania and Latvia was performed. There is a discrepancy in the decisions on the marketing authorization vs the reimbursement in Lithuania and Latvia (reimbursement of haloperidol and trihexyphenidyl for the off-label treatment of dementia). National legislation on the drug reimbursement in Lithuania and Latvia does not provide safeguards for public health at the same level as the marketing authorization does. Absence of a revision of former decisions in the light of new evidence is a critical weakness of the drug reimbursement in Lithuania and Latvia. Reimbursement for the off-label indications may pose a risk to public health.
- Published
- 2018