Background information about the National Dementia Strategy

Status and historical development of the National Dementia Strategy

A National Dementia Strategy is currently being developed in Cyprus

Treatment and research

Issues relating to medical treatment

The availability of medicines in general

Pharmaceutical products are provided by the pharmacies of hospitals/institutions[1]. There is a list of drugs which can be prescribed and patients fall into one of two categories which determine how much they have to pay for those drugs. This list is regularly updated. The first category covers people who are entitled to receive medical drugs free of charge. This includes patients suffering from certain chronic diseases and people who are on Public Assistance as well as their dependants. The second category covers people who are entitled to a reduced rate based on the level of their income. The people in the second category must pay 50% of the cost. In addition, there is a co-payment system which applies to approximately 100 medicinal products which are provided by private pharmacies. For these drugs, patients must pay a pre-determined amount for each medicinal product.

The availability of Alzheimer treatments

All four AD drugs are available in Cyprus. The availability and part reimbursement of AD drugs has been improved in Cyprus due to the successful lobbying of the Cyprus Alzheimer Association.

In 2000, the Cyprus Alzheimer Association requested the Minister of Health to provide free medication in state hospitals for AD patients. This request was granted and subject to the annual tender legislation procedures, one medication out of three (i.e. donepezil, rivastigmine or galantamine) is provided free of charge. This may be a different one each year. Memantine is not included in the annual tender.

Conditions surrounding the prescription and reimbursement of AD drugs

Every year, the three companies which produce donepezil, rivastigmine or galantamine need to make a bid-tender so that the government can determine which is offering the lowest price. That drug is then purchased by the government and made available in state hospitals where patients can then obtain it free of charge provided that it has been prescribed by their GP. All people with Alzheimer’s disease are entitled to attend hospital. They need to pay a minimal fee for registration.

A few years later, the Cyprus Alzheimer Association requested that a 40% subsidy be given as compensation for the other two AD drugs (which patients would have to purchase themselves). This was the case until 2012 when, due to the economic crisis, the subsidy was reduced to 25%.

Due to this tender system, nearly every year a different AD drug is provided free of charge in hospitals. Patients who use one of those which are not free for the current year have to buy it privately and are subsequently only reimbursed for 25% of the cost.

Memantine had not yet obtained Community-wide marketing authorization when the original agreement was made with the Minister of Health to make AD drugs available and to establish a system of reimbursement. Consequently, it is not part of the tender agreement and is only ever reimbursed at the rate of 25%.

Issues relating to research

Cyprus is not involved in the EU Joint Programme – Neurodegenerative Disease Research (JPND) but is a Collaborator in the Joint Action “Alzheimer Cooperative Valuation in Europe (ALCOVE)”.

Acknowledgements

Noni Diakou, Cyprus Alzheimer Association

[1] European Commission (2011): 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