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Italy

Reimbursement of anti-dementia drugs

The availability of medicines in general

Medicines in Italy are included in one of the three following groups:

  • Group A is for medicines termed “essential” for the treatment of more serious diseases and conditions and are free of charge for people insured except for the fixed amount for the prescription.
  • Group C is for other medicines and for over-the-counter medicines. For these medicines, the cost is borne in totality by the insured person,
  • Group H is for medicines free of charge but limited to use in hospitals or out of hospitals according to the laws of the Italian regions. [1]

The availability of Alzheimer treatments

All anti-dementia drugs are available in Italy and with the exception of memantine are reimbursable under strict conditions. The Italian government launched the Cronos project in 2000 to assess the impact of a multi-level therapeutic approach which included a two year free-of-charge treatment with acetylcholinesterase inhibitors.

Reimbursement is limited to persons participating in this project and requires a diagnostic assessment in one of the 503 Alzheimer Evaluation Units set up for this project. The first six months of the treatment are provided free of charge by the pharmaceutical companies manufacturing the medicines. The project provides specialists with a diagnostic protocol they need to follow. Treatment with acetylcholinesterase inhibitors is open for people with an MMSE score between 26 and 10 and memantine for people with MMSE scores below 14.

There are no specific restrictions as to the access of people living alone or in nursing homes to available Alzheimer treatments.

 

Donepezil

Rivastigmine

Galantamine

Memantine

Reimbursement

Yes

Yes

Yes

No [2]

Initial treatment decision

Alzheimer Evaluation Units

Alzheimer Evaluation Units

Alzheimer Evaluation Units

N/A

Continuing treatment decision

Alzheimer Evaluation Units

Alzheimer Evaluation Units

Alzheimer Evaluation Units

N/A

Required examinations

Diagnostic protocol

Diagnostic protocol

Diagnostic protocol

N/A

MMSE limits

26-10

26-10

26-10

N/A

People living alone

No restrictions

No restrictions

No restrictions

N/A

People in nursing homes

No restrictions

No restrictions

No restrictions

N/A

[1] European Commission (2006): MISSOC – Mutual information system on social protection : Social protection in the Member States of the European Union, of the European Economic Area and in Switzerland : Comparative tables

[2] Certain Italian regions may have different reimbursement rules. In Trentino for example, memantine can be reimbursed.

 

 
 

Last Updated: mercredi 15 juillet 2009

 

 
 

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