Sharp Rise in Prescribing Drives Drug Spending
By Karen Pallarito
Originally published by Reuters Health, July 9, 2002
NEW YORK (Reuters Health) — Physicians are prescribing medications at a far faster clip than they did two decades ago, a trend that is likely to result in a doubling of drug spending in the next 5 years, according to a new federal study released on Tuesday in the journal Health Affairs.
Between 1985 and 1999, the prescribing rate rose 34%, from 109 to 146 prescriptions per 100 visits, the study found. All major therapeutic classes, except for microbial agents such as penicillin and tetracycline (which fell 12%) experienced increases during the study period.
About two thirds of the increase can be accounted for by an aging patient population and more complicated medical conditions, the research found. But other factors, such as the availability of new drug formulations to treat chronic conditions, wider health insurance and drug coverage, and growth of direct-to-consumer advertising are also believed to contribute to the increased prescribing rate.
The trend is likely to continue as baby boomers grow older and scientific discoveries lead to better treatment of acute and chronic conditions, concludes study author Catharine Burt, chief of the ambulatory care statistics branch of the National Center for Health Statistics at the Centers for Disease Control and Prevention.
Burt's analysis is based on data from the National Ambulatory Medical Care Survey, a survey of office-based physicians conducted by the National Center for Health Statistics. The survey captures all "drug mentions," meaning prescriptions, over-the-counter preparations and immunizations ordered, supplied or administered during a visit.
Psychiatrists had the largest increase in drug mentions, jumping to 178 drugs per 100 visits in 1999, from 82 per 100 visits in 1985.
Just six therapeutic classes accounted for 80% of the increase in the overall drug mention rate. Those classes include central nervous system drugs, hormones, respiratory medications, pain relief agents, metabolics/nutrients and cardiovascular-kidney drugs.
Antidepressants accounted for 13.5% of the increase in overall ambulatory drug prescribing. Cholesterol-lowering drugs and heart medications called ACE inhibitors were also top contributors.
For seniors, the largest increase was for drugs affecting the blood and blood-forming tissues, which jumped 187% during the study period. For adults 45 to 64, metabolic drugs, including cholesterol-lowering medications, had the largest increase in drug mentions, up 109%.
Central nervous system drugs had the highest increase for children, up a startling 327%. The study finds that the attention-deficit/hyperactivity disorder drug Ritalin was among the most frequently mentioned drugs in this class during children's visits in 1999.
