gms | German Medical Science

Background: Ginkgo biloba drugs (Gb) are reimbursed within the German statutory health insurance (SHI) scheme for the treatment of dementia. In 2008, a novel Gb product with 240 mg tablets was introduced aiming to facilitate medication use and adherence by incorporating the recommended daily dose in one single tablet. The objective of this study was to investigate patients’ persistence with Gb therapy, with dosage strength as a hypothetically influential factor.

Materials and Methods: A retrospective cohort study was performed using claims data for outpatient prescriptions within the German SHI system. Persistence was defined as continuous treatment with an allowable gap of 20% between refills. Multivariate regression models were conducted to identify variables associated with persistence.

Results: Among 13,810 patients initiating treatment with Gb in 2008, 430 (3.1%) received a 240 mg dosage form, 7,070 (51.2%) a 120 mg dosage form and 6,310 (45.7%) a dosage form containing less than 120 mg Gb per single dose. After 6 months, persistence was highest for patients initially treated with the 240 mg dosage form (22.8% of patients), although persistence was very low in general (5.7% of patients treated with 120 mg). The risk for non-persistence was significantly reduced for patients receiving the 240 mg strength product compared to 120 mg strength products (HR=0.63; 95% CI 0.57–0.70).

Conclusion: Patients initially treated with Gb 240 mg were more persistent compared to those receiving lower strength dosage forms. Nevertheless, persistence with Gb therapy was generally low and should be improved in order to better realize therapeutic effects.