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 diabetes.
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 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 instance.
Medco's data show
that last year, 51% of American children and adults
were taking one or more prescription drugs for a chronic
condition, up from 50% the previous four years and 47%
in 2001. Most of the drugs are taken daily, although
some are needed less often.
The company
examined prescription records from 2001 to 2007 of a
representative sample of 2.5 million customers, from
newborns to the elderly.
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% of adult
men.
- Three out of
four people 65 or older.
Among seniors,
28% of women and nearly 22% 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% 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.
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. (AP)
