OBJECTIVES: Our aim was to examine prescription filling behaviors and subsequent medication adherence among Alzheimer’s disease (AD) patients. We distinguished between Mail and Retail cohorts, and a one-year follow-up enabled a thorough evaluation of adherence and Healthcare Resource Utilization.

METHODS: We utilized the de-identified Normative Health Information database to identify AD patients through ICD-10-CM codes from January 1st to December 31st, 2021, in the Commercial and Medicare Advantage segments. Post-index, we examined continuous eligibility for medical and pharmacy benefits for 15 months, focusing on patients filling prescriptions for Cholinesterase Inhibitors (Rivastigmine, Galantamine, Donepezil) or N-methyl-D-aspartate receptor antagonist (Memantine) within three months of the initial AD claim. The patient pool was bifurcated into mail and retail, excluding dual-mode users. Propensity score matching (PSM) was applied to demographics and Charlson Comorbidity Index (CCI) variables to mitigate potential bias. The cohorts were then followed for a year to evaluate adherence (PDC) and healthcare resource utilization.

RESULTS: Before PSM application, the initial pool comprised 115,568 eligible patients. Post-PSM, cohort sizes for Rivastigmine, Galantamine, Donepezil, and Memantine were 1,070, 3,031, 3,874, and 3,746, respectively. Interestingly, mail-ordered drugs showed significantly higher adherence compared to retail: Donepezil (84% vs 77.1%), Memantine (83.8 % vs. 75.5%), Galantamine (78.2 % vs. 67%), and Rivastigmine (70.8% vs 66.3%). Further exploration into healthcare resource utilization for these cohorts is ongoing.

CONCLUSIONS: Our results indicate a significant link between prescription filling methods and medication adherence in AD patients. Mail-ordered prescriptions displayed superior adherence, underlining the potential impact on patient outcomes. Ongoing research into healthcare resource utilization will offer a more holistic understanding of the implications for clinical practice and healthcare policy.