[Pharmwaste] More Americans are taking prescription medications

DeBiasi,Deborah dldebiasi at deq.virginia.gov
Thu May 15 11:13:43 EDT 2008


Thursday, May 15, 2008
Posted on Wed, May. 14, 2008 

More Americans are taking prescription medications

For the first time, it appears that more than half of all insured
Americans are taking prescription medicines regularly for chronic health
problems, a study shows.

The most widely used drugs are those to lower high blood pressure and
cholesterol - problems often linked to heart disease, obesity and

The numbers were gathered last year by Medco Health Solutions Inc.,
which manages prescription benefits for about one in five Americans.

Experts say the data reflect not just worsening public health but better
medicines for chronic conditions and more aggressive treatment by
doctors. For example, more people are now taking blood pressure and
cholesterol-lowering medicines because they need them, said Dr. Daniel
W. Jones, president of the American Heart Association.

In addition, there is the pharmaceutical industry's relentless
advertising. With those factors unlikely to change, doctors say the
proportion of Americans on chronic medications can only grow.

"Unless we do things to change the way we're managing health in this
country ... things will get worse instead of getting better," predicted
Jones, a heart specialist and dean of the University of Mississippi's
medical school.

Americans buy much more medicine per person than any other country. But
it was unclear how their prescriptions compare to those of insured
people elsewhere. Comparable data were not available for Europe, for

Medco's data show that last year, 51 percent of American children and
adults were taking one or more prescription drugs for a chronic
condition, up from 50 percent the previous four years and 47 percent in
2001. Most of the drugs are taken daily, although some are needed less

The company examined prescription records from 2001 to 2007 of a
representative sample of 2.5 million customers, from newborns to the

Medication use for chronic problems was seen in all demographic groups:

- Almost two-thirds of women 20 and older.

- One in four children and teenagers.

- 52 percent of adult men.

- Three out of four people 65 or older.

Among seniors, 28 percent of women and nearly 22 percent of men take
five or more medicines regularly.

Karen Walker of Paterson, N.J., takes 18 prescription medicines daily
for high blood pressure, diabetes, chronic back and shoulder pain,
asthma and the painful muscle disorder fibromyalgia.

"The only way I can do it and keep my sanity ... is I use pill boxes" to
organize pills for each morning and night, said Walker, 57, a full-time
nurse at an HIV clinic. Her 69-year-old husband, Charles, keeps his
medicines lined up on his bureau: four pills for arthritis and heart
disease, plus two inhalers for lung problems.

Dr. Robert Epstein, chief medical officer at Franklin Lakes, N.J.-based
Medco, said he sees both bad news and good in the findings.

"Honestly, a lot of it is related to obesity," he said. "We've become a
couch potato culture (and) it's a lot easier to pop a pill" than to
exercise regularly or diet.

On the good side, he said, researchers have turned what used to be fatal
diseases into chronic ones, including AIDS, some cancers, hemophilia and
sickle-cell disease.

Yet Epstein noted the biggest jump in use of chronic medications was in
the 20- to 44-year-old age group - adults in the prime of life - where
it rose 20 percent over the six years. That was mainly due to more use
of drugs for depression, diabetes, asthma, attention-deficit disorder
and seizures.

Antidepressant use in particular jumped among teens and working-age
women. Doctors attributed that to more stress in daily life and to
family doctors, including pediatricians, being more comfortable
prescribing newer antidepressants.

Dr. Sidney Wolfe of Public Citizen's Health Research Group said the
increased use of medications is partly because the most heavily
advertised drugs are for chronic conditions, so most patients will take
them for a long time. He also blames doctors for not spending the time
to help patients lose weight and make other healthy changes before
writing a prescription.

The study highlights a surge in children's use of medicines to treat
weight-related problems and other illnesses previously considered adult
problems. Medco estimates about 1.2 million American children now are
taking pills for Type 2 diabetes, sleeping troubles and gastrointestinal
problems such as heartburn.

"A scarier problem is that body weights are so much higher in children
in general, and so we're going to have larger numbers of adults who
develop high blood pressure or abnormal cholesterol or diabetes at an
earlier age," said Jones, of the heart association.

Dr. Richard Gorman, an American Academy of Pediatrics expert on
children's medicines, said more children are taking medicines for "adult
conditions" partly because manufacturers now provide pediatric doses,
liquid versions or at least information to determine the right amount
for a child.

The Medco study found that among boys and girls under age 10, the most
widely used medication switched from allergy drugs to asthma medicines
between 2001 and 2007. Gorman said that's because over the last decade,
asthma care has gone from treating flare-ups to using inhaled steroids
regularly to prevent flare-ups and hospitalizations.

Deborah L. DeBiasi
Email:   dldebiasi at deq.virginia.gov
WEB site address:  www.deq.virginia.gov
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