Background information about the National Dementia Strategy

There is as yet no national dementia strategy in Austria.

Diagnosis, treatment and research

Issues relating to diagnosis

This is not addressed at national level.

Which healthcare professionals are responsible for diagnosing dementia

GPs are permitted to diagnose dementia and/or Alzheimer’s disease and they do. The diagnosis can also be made by a specialist doctor (i.e. a neurologist, psychiatrist or geriatrician). GPs do not have set consultations times and there are no incentives to encourage timely diagnosis. They do not, for example, receive additional payment for special examinations to diagnose Alzheimer’s disease.

Type and degree of training of GPs in dementia

GPs do not receive special training in dementia during their professional training to become a GP and continuing education is voluntary.

Required tests to diagnose dementia

There are no official guidelines, recommendations or tests which must be used in order to diagnose dementia and/or Alzheimer’s disease. The MMSE and clock drawing tests are most commonly used.

Issues related to medical treatment

The availability of medicines in general

Austria keeps a list of pharmaceutical products for which expenses are covered by the healthcare system. Nevertheless, patients and carers need to cover part of the costs of medicines. This charge is currently set at EUR 5.15 per item prescribed. For infectious diseases and in cases of need, medicines may be free of charge.^[1]

The availability of Alzheimer treatments

All four AD drugs are available in Austria and are included on the list of pharmaceutical products that are covered by the healthcare system.

Conditions surrounding the prescription and reimbursement of AD drugs

Prescription is limited to specialist doctors and this applies to treatment initiation, as well as to continuing treatment decisions although continued treatment would be refunded for six months if prescribed by a GP. For the prescription of acetylcholinesterase inhibitors, an MMSE is required. Treatment with acetylcholinesterase inhibitors is limited to people with an MMSE between 26 and 10, whereas treatment with memantine is reimbursed for patients scoring between 14 and 3 on this scale.

Medicines for people living alone and for people in nursing homes are also covered by the healthcare system. However, in the case of people with dementia living alone, there must be a carer who can ensure that the person with dementia takes the medication. 

Bi-therapy with an acetylcholinesterase inhibitor and memantine is officially excluded from reimbursement in Austria which means that patients would have to pay for one of the drugs except in well-founded cases (www.erstattungskodex.at).

Issues related to research

There are some research programmes but not on a national level. Austria is involved in the EU Joint Programme – Neurodegenerative Disease Research (JPND) but not in the Joint Action “Alzheimer Cooperative Valuation in Europe (ALCOVE)”.

Acknowledgements

Antonia Croy, President, Alzheimer Austria

Roswitha Bartsch

[1] European Commission (2012): 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