Use of choline alfoscerate for newly diagnosed patients with Alzheimer’s disease in Korea

Abstract

Abstract Purpose: Choline alfoscerate, a cholinergic precursor in the brain, improves dementia-related symptoms. Although it is widely available as a dietary supplement in several countries, including the U.S., the Korean healthcare system has incorporated it into its insurance coverage. Therefore, in this study, we aimed to investigate the utilization status of choline alfoscerate and factors influencing it in patients newly diagnosed with Alzheimer’s disease (AD) using real-world data.Methods: We analyzed the Health Insurance Review and Assessment Service research dataset to identify patients ≥ 60 years old who were newly diagnosed with AD. We determined whether the study population was prescribed choline alfoscerate in addition to AD medications (donepezil, rivastigmine, galantamine, and memantine) within 60 d of the initial diagnosis. Moreover, the Cochran–Armitage test was used to confirm the statistical differences in the annual drug utilization trends.Results: Among the 330,326 study participants, 99,845 (33.08%) were consuming choline alfoscerate. Its use increased from 15.96% in 2012 to 47.65% in 2019. Factors that positively influenced the use of choline alfoscerate included male sex, MedAid insurance, and osteoarthritis. However, its use tended to decrease in the presence of certain comorbidities (hypertension, congestive heart failure, stroke/transient ischemic attack, chronic kidney disease, and depression).Conclusion: Utilization of choline alfoscerate has gradually increased in Korea, in part due to the absence of a disease-modifying therapy for AD and its inclusion in the country’s insurance coverage system. However, its use should be monitored due to the unclear efficacy and risk profile of this drug.