Inequality in Prescribing Anti-dementia Medications in Iran: Evidence From Social Security Insurance Claim Data

The prescribed doses of medications used for chronic diseases can be a good index for assessing inequality in healthcare services employment in communities. This study aimed to evaluate inequality in the prescribed dose of anti-dementia medications from 2012 to 2015 in the claim data, in Iran.

This study used the data on the prescribed dose of anti-dementia medications registered by the Social Security Organization (SSO) of Iran. The data on wealth index and educational attainment were extracted from Household, Income, and Expenditure Surveys (HIES) and merged into the claim data. Univariate and multivariable ordinal logistic regression models were applied to evaluate the factors associated with the prescribed dose of antidementia medications. DASP Stata package was used to calculate Gini and concentration indices.

In multivariable models, prescription year, age, and educational attainment were related to the prescribed dose of anti-dementia medications. From 2012 to 2015, Gini indices of the prescribed dose of donepezil and rivastigmine were decreased. Gini indices in wealthier subjects were smaller than that in poorer individuals. Furthermore, with increasing the subjects’ age up to the age of 80 years, Gini indices were decreased. Concentration indices were positive about rivastigmine, donepezil and memantine.

Different levels of inequality in the prescribed doses of donepezil and rivastigmine were observed among various wealth and education quintiles. Inequality in the prescribed doses of both mentioned medications was reduced from 2012 to 2015 among individuals under the SSO coverage in Iran.