Medication Adherence and Cost of Care for Comorbid Conditions in Patients with Early Alzheimer's Disease: A Retrospective Cohort Study Using the Axon Registry and Claims Data
Lei Lv1, Abdalla Aly1, Caroline McKay1, Paul Mystkowski1, Shannon Gallagher2, Kristian Garcia2, Heather E. Moss3, Soeren Mattke4
1Novo Nordisk Inc., 2Verana Health, 3Department of Ophthalmology & Department of Neurology & Neurological Sciences, Stanford University, 4University of Southern California
Objective:
To better understand medication adherence and associated costs of care in early Alzheimer’s Disease (eAD).
Background:

Patients with eAD typically have multiple comorbidities and take multiple medications. The complexity of taking multiple medications combined with cognitive impairment might increase the risk for poor medication adherence.

Design/Methods:

Retrospective cohort study utilizing de-identified medical record data from the American Academy of Neurology's Axon Registry linked to patient-level claims data. Patients with eAD, classified as mild cognitive impairment (MCI) due to AD or mild AD due to dementia based on cognitive test scores, were included from January 2015–March 2023. Patient demographics, comorbidities, cost of care and medication adherence across 10 selected classes of chronic conditions were assessed. Medication adherence was evaluated using mean proportion of days covered (PDC) and adherence rate (AR), defined as the proportion of patients with PDC ≥80% from the first fill through to the end of the first year.

Results:

Our study included 333 patients with eAD (MCI due to AD: 98; mild AD dementia: 235). Mean (SD) patient age was 76.8 (7.8) years. Cardiometabolic comorbidities were common, including hypertension (56.8%), hyperlipidemia (49.2%) and cardiovascular disease (30.0%). Across all 10 medication classes, mean (SD) PDC was 74.4% (1.7). Cholinesterase inhibitors were the most taken medication, used by 63.4% of patients (mean [SD]: PDC=72.0% [28.4]; AR=50.4%). Statins were taken by 46.8% of patients (mean [SD]: PDC=78.8% [23.8]; AR=60.5%) and serotonin–norepinephrine reuptake inhibitors/selective serotonin reuptake inhibitors by 38.4% (mean [SD]: PDC=74.6% [26.9]; AR=54.7%). Among the 10 medication classes, mean number of medications per patient was 3.0, and mean (SD) annual pharmacy and medical costs were $3,452 (13,188) and $13,709 (23,004), respectively.

Conclusions:

Patients with eAD commonly had comorbidities taking multiple medications, with suboptimal medication adherence and high healthcare and pharmacy costs.

Previously presented at CTAD25 and published in JPAD (Lv et al. 2025;DOI:TBC )

10.1212/WNL.0000000000215559
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