|PUBLIC POLICY & ADHERENCE
Other Drug Problem: Statistics on Medicine Use and Adherence
In 1989, the National
Council on Patient Information and Education (NCPIE) coined the phrase,
"America's Other Drug Problem" in a report on children and medicines.
In 1997, NCPIE produced a documentary, "The
Other Drug Problem," with New York public television station, WLIW.
Since then, other organizations have adopted this phrase when referring
to prescription medicine misuse.
|Medicine Use Statistics
- In 2003, the number of retail prescriptions was 3.22 billion, up 2.4% from 2002. By 2010, the volume is projected to reach 4.5 billion prescriptions. (National Association of Chain Drug Stores)
- In 2003, retail prescription drug sales were $203.1 billion, up 11.2% from 2002. (NACDS)
- In 2003, the average price of a prescription was $59.28 vs. $54.81 in 2002. (NACDS)
- In 2002, 64.8% of physician office visits ended with a prescription being written. (National Ambulatory Medical Care Survey, 2002)
- In 1998, over four-fifths of visits to cardiologists included a prescription being written, while less than one-fifth (18%) of visits to general surgeons included a prescription (Ibid).
- In 1998, of the physician office visits involving medication therapy, 36.5% of patients received two or more prescriptions; over 10% received four or more prescriptions (Ibid).
- In 2003, the 10 most frequently prescribed brand-name medicines were, in order: Lipitor, Synthroid, Norvasc, Zoloft, Zithromax Z-Pak, Toprol XL, Zocor, Prevacid, Premarin Tabs, Ambien (Drug Topics, 2004)
- In 2003, the top 10 brand-name prescription medicines by retail sales were: Lipitor, Prevacid, Zocor, Nexium, Zoloft, Celebrex, Zyprexa, Neurontin, Effexor XR (Drug Topics, 2004)
- Through the year 2010, the fastest-growing age cohort will be those aged 45-64. After 2010, those aged 65 and older will be the fastest-growing cohort.
- The elderly (aged 65 and older) account for 13% of the U.S. population, but account for 34% of all prescription medicines dispensed, and for 42% of retail prescription expenditures (Cost Overdose: Growth in Drug Spending for the Elderly, 1992-2010, Washington, DC: Families USA, July 31, 2000).
- The average number of prescriptions per elderly person is projected to be 28.5 in 2000, and is estimated to reach 38.5 prescriptions by 2010 (Cost Overdose, Ibid).
- In 1999, based on an eight-state study of community pharmacies, 87% of patients received written information with their prescriptions. However, only 35% of pharmacists made any reference to the written leaflet, and only 8% actually reviewed it with the patient (B. Svarstad, Univ. of Wisconsin-Madison, FDA-commissioned research presented in Feb. 2000, Rockville, MD; and in June 2000, Kuopio, Finland).
- By 2010, 95% of patients should receive from their prescribers and pharmacists verbal counseling on appropriate use and potential risks of medications (Healthy People 2010, Objective 17-5, Jan. 2000).
- As many as 40% of cancer patients are taking unconventional medical therapies but don't tell their physicians unless specifically asked. Examples of such therapies included St. John's wort, shark cartilage, and megadoses of vitamins (J. Metz, Univ. of Pennsylvania Cancer Center, in R. Voelker, "Do Ask, Do Tell," JAMA, Vol. 283, No. 24, June 28, 2000).
- Researchers found a 76% discrepancy rate between what medicines patients were prescribed, and what medicines (Rx and non-prescription) they actually took. Of those discrepancies, 51% stemmed from patients taking medicines not recorded; 29% were from patients not taking a recorded medicine; and 29% were from differences in dosages (S. Bedell et. al., "Discrepancies in the Use of Medica-tions," Archives of Internal Medicine, Vol. 160, July 24, 2000).
- Over half of medication-related injuries identified in a study of 18 community nursing homes were preventable. Psycho-active drugs (antipsychotics, sedatives, antidepressants, and hypnotics) were the most common medications associated with preventable adverse drug events, the researchers found. Given the country's 1.5 million nursing home residents, if the findings are extrapolated, then at least 350,000 ADEs occur each year, over half of which are preventable (Gurwitz et. al., American Journal of Medicine, forth-coming; see National Institute on Aging news release, Aug. 9, 2000, at: www.nih.gov/nia/news/pr/2000/0809.htm
- The leading causes of death in 1998 in the U.S. were, in order: heart disease (724,000), cancer (538,000), stroke (158,000), chronic lung obstruction (114,000), pneumonia and influenza (94,000), accidents (93,000), diabetes mellitus (64,000), suicide (29,000), kidney disease (26,000), and chronic liver disease (24,000).1
- Adverse drug reactions (ADRs) may be the 4th-to-6th leading cause of death in the U.S.: researchers found that in 1994, over 2.2 miliion hospitalized patients had serious ADRs, and 106,000 patients had fatal ADRs. Serious ADRs occured in 6.7 percent of hospitalized patients.2
- Since 1990, sales of non-prescription medicines (OTCs) have increased by more than 60 percent. In 1999, sales of OTCs are expected to top $20 billion. Sales of dietary supplements are expected to reach $17 billion by the year 2000.3
- Expenditures on direct-to-consumer advertising has grown 50% per year since 1997, totalling $1.9 billion in 1999. A decade ago, spending was just $12 million.
- Among Medicare beneficiaries, 87% need to fill at least one prescription each year. Over half (56%) of these beneficiaries use prescription medicines costing $500 or more; 38% require medicines costing $1,000 or more. One in three Medicare beneficiaries has no prescription drug coverage.4
- U.S. Centers for Disease Control, National
Center for Health Statistics, Dept. of HHS, October 1999.
- Lazarou, J., Pomeranz, B., Corey, P., "Incidence
of Adverse Drug Reactions in Hospitalized Patients," Journal of the American
Medical Association, Vol. 279, No. 15, April 15, 1998, pps. 1200-1205.
- Consumer Healthcare Products Association,
Drug Topics, April 5, 1999, p. 43; "Rite Aid, GNC Form an Alliance, The
Washington Post, Jan. 8, 1999, p. F3.
- Michael Hash, Health Care Financing Administration,
Dept. of HHS, prepared statement, Subcommittee on Health and the Environment,
House of Representatives, U.S. Congress, Sept. 28, 1999.