Report: Almost half of Americans use at least one prescription drug

Almost half of all Americans take at least one prescription medicine and one in six take three or more medications, according to the U.S. Department of Health and Human Services’ annual checkup on Americans’ health.

The report, Health, United States 2004, presents the latest health data collected by the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics and dozens of other federal health agencies, academic and professional health associations, and international health organizations.

The latest report shows prescription drug use is rising among people of all ages, and use increases with age. Five out of six people age 65 and older are taking at least one medication, and almost half the elderly take three or more.

Adult use of antidepressants almost tripled between 1988-1994 and 1999-2000. Ten percent of women age 18 and older and 4% of men now take antidepressants. Prescriptions for nonsteroidal anti-inflammatory drugs, antidepressants, blood glucose/sugar regulators, and cholesterol-lowering statin drugs, in particular, increased notably between 1996 and 2002.

The National Health and Nutrition Examination Survey found a 13% increase between 1988-1994 and 1999-2000 in the proportion of Americans taking at least one drug and a 40% jump in the proportion taking three or more medicines. Forty-four percent reported taking at least one drug in the past month and 17% were taking three or more in the 2000 survey.

The annual report to Congress showed that health expenditures climbed 9.3% in 2002 to $1.6 trillion. Although prescription drugs comprise only one-tenth of the total medical bill, they remain the fastest growing expenditure. The price of drugs rose 5%, but wider use of medicines pushed total expenditures up 15.3% in 2002. Drug expenditures have risen at least 15% every year since 1998.

Other findings include:

  • Three times as many white adults as black or Hispanic adults took antidepressants.
  • Boys were prescribed drugs to treat attention deficit hyperactivity disorder twice as often as girls, but antidepressants were prescribed to boys and girls at the same rates.
  • Private health insurance covered almost half of prescription drug costs in 2002, up from a quarter in 1990. People paid 30% out of their own pockets.

The full Health, United States report is available on the CDC web site at www.cdc.gov/nchs/.

FDA announces new radio- frequency ID initiative for drugs

The U.S. Food and Drug Administration (FDA) has published a Compliance Policy Guide (CPG) for implementing radiofrequency identification (RFID) feasibility studies and pilot programs that are designed to enhance the safety and security of the drug supply. The FDA says this action continues its commitment to promote the use of RFID by the U.S. drug supply chain by 2007.

In a related action, the FDA announced that it is creating an internal RFID Workgroup whose charge is to monitor adoption of RFID in the pharmaceutical supply chain, proactively identify regulatory issues raised by the use of this new technology, and develop straightforward processes for handling those issues. The FDA contends that the workgroup will improve communication with members of the supply chain on RFID-related issues and should facilitate both the performance of pilot studies and the collection of data needed to formulate policy.

The FDA also applauded the initiatives announced by the pharmaceutical companies Pfizer, GlaxoSmithKline, and Purdue Pharma, all of which plan to place RFID tags on at least one of their products.

RFID technology makes it easier to ensure that drugs are authentic, and it also creates an electronic pedigree, or record of the chain of custody, from the point of manufacture to the point of dispensing, the FDA says. Electronic pedigrees should allow wholesalers and retailers to rapidly identify, quarantine, and report suspected counterfeit drugs and conduct efficient, targeted recalls. The FDA considers electronic pedigrees to be a type of "electronic safety net" that uses technology that allows illicit drug transactions to be rapidly identified and, potentially, transmitted to the FDA.

These actions are steps in implementing a major recommendation of the FDA’s report, issued Feb. 18, 2004, titled "Combating Counterfeit Drugs." The report recommended that RFID technology be in widespread use throughout the pharmaceutical industry by 2007. The FDA will consider all public comments in any revision of the CPG.

Those interested in commenting on the CPG may submit their comments to: www.fda.gov/dockets/ecomments/.

FDA strengthens labels on two types of antibiotics

The U.S. Food and Drug Administration (FDA) has announced labeling changes regarding penicillin G benzathine and penicillin G procaine injectable suspension (Bicillin CR) and penicillin G benzathine injectable suspension (Bicillin LA). These changes include: 1) a new boxed warning against intravenous use, which has been associated with serious adverse effects in post-marketing reports, including cardiorespiratory arrest and death; and 2) a precautionary note for penicillin G benzathine and penicillin G procaine injectable suspension explaining it is not for treatment of syphilis.

King Pharmaceuticals, the manufacturer of these products, has also issued a "Dear Doctor" letter, highlighting these changes. The letter reminds practitioners that penicillin G benzathine injectable suspension is the only currently approved penicillin G benzathine product indicated for the treatment of syphilis and that penicillin G benzathine and penicillin G procaine injectable suspension should not be administered in place of penicillin G benzathine injectable suspension for this purpose. Administration of penicillin G benzathine and penicillin G procaine injectable suspension instead of penicillin G benzathine injectable suspension in the treatment of syphilis may result in inadequate treatment.

To help health professionals better distinguish between the two types of antibiotic, King Pharmaceuticals has modified the cartons and syringe labels. The background colors for the CR cartons have been changed from white to pale green (Bicillin CR) and pale purple (Bicillin CR 900/300). Bicillin LA cartons will retain the white background. The statement "Not for the Treatment of Syphilis" has also been added in red text to both the Bicillin CR and Billin CR 900/300 syringe labels.

For more information, see www.fda.gov/bbs/topics/ANSWERS/2004/ANS01329.html.

Rx drug law may help low-income Medicare beneficiaries

Low-income people with Medicare who sign up for new Part D drug plans and receive the additional subsidies — an estimated 8.7 million people — are projected to pay 83% less for prescription drugs in 2006 than they would have spent if the Medicare drug law had not been enacted, according to a new report released today by the Kaiser Family Foundation in Washington, DC. Those who enroll in the new drug benefit but do not receive the low-income subsidies — an estimated 20.3 million people — are projected to pay on average 28% less out-of-pocket for their prescription drugs as a result of the new law, the analysis finds.

The report, based on a model developed by Actuarial Research Corp. (ARC) for the Foundation, estimates out-of-pocket drug spending in 2006 among the 29 million people the Congressional Budget Office (CBO) expects will sign up for Medicare drug plans.

The simulation model generally conforms to CBO’s assumptions and projections about Medicare drug benefit spending and participation rates for the new benefit, known as Medicare Part D, and for the low-income subsidy. The projections of out-of-pocket drug spending are based on the likely response of Medicare beneficiaries to the new law. They do not reflect the effects of supplemental coverage that beneficiaries might obtain or take into account premiums paid by beneficiaries, which are estimated by CBO to average $420 for the new Medicare benefit in 2006.

Overall, the analysis projects that three out of four who enroll in plans offering the new benefit (21.6 million people) are expected to have the same or lower out-of-pocket spending in 2006 than they would have without the new Medicare drug law.

The other one in four (7.4 million people) are expected to have higher out-of-pocket spending without taking into account the premium costs for the new coverage, unless they get supplemental coverage from another source.

For most (about 5 million people), the increases are expected to be modest — $250 or less. The 2.4 million people who are projected to face even higher out-of-pocket costs under the new drug benefit in 2006 includes those with relatively high out-of-pocket drug costs who are projected to lose access to more generous prescription drug coverage than the new Medicare benefit provides, especially people who lose their employer plan coverage.

The report and other materials are available on-line at www.kff.org/medicare/med112204pkg.cfm.