Are we taking too many drugs?
The Twitterverse is abuzz over a new study released by the Mayo Clinic which found that 70 percent of Americans are taking at least one prescription drug.
A second independent study, conducted by the IMS Institute for Healthcare Informatics, provides relevant insights. IMS found that if we used prescription drugs more wisely, the U.S. could save at least $213 billion a year in health-care expenses. The key is reducing medication overuse, underuse, and improper use.
Dozens of earlier studies have shown that taking prescribed drugs properly reduces overall health-care costs, and the newer the drug, the greater the reduction in other health expenses. The two new studies provide more detailed information to quantify where money is being spent and misspent on health care.
IMS, part of data-analysis and consulting firm IMS Health, said $213 billion could be saved if doctors and patients would make better use of medication, including timely diagnoses so patients get treatment earlier in the course of an illness and taking medicines as directed by the doctor.
The savings represent nearly 8 percent of the $2.8 trillion the U.S. will spend on health care this year – which could pay for everyone in the country to have health coverage several times over without the massive taxes and Medicare cuts of the Affordable Care Act.
IMS researchers generally focused on the spending on a handful of very common or very expensive diseases — from high cholesterol and blood pressure to HIV and diabetes — for which the costs of care and complications are well documented.
Murray Aitken, IMS executive director, told the Associated Press that more-appropriate use of medications — taking them exactly as prescribed, not taking antibiotics for viral illnesses, preventing medication errors, and the like — could prevent six million hospitalizations, four million trips to the emergency room, and 78 million visits to doctors and other outpatient-care providers each year.
“Those are staggering numbers,” Aitken said.
The IMS report, titled “Avoidable Costs in Healthcare,” found the biggest area of waste is patients not taking medicines prescribed by their doctor at all or not taking them as directed. IMS estimates the cost of such “non-adherence” at about $105 billion a year.
The IMS study shows that misuse of antibiotics for viral illnesses is one of the most common misuses of prescription drugs. And the Mayo Clinic study shows that the most common drugs Americans take are antibiotics — 17 percent among those studied. IMS found the misuse of antibiotics contributes to an estimated $34 billion each year in avoidable inpatient-care costs. An additional $1 billion is spent on about 31 million inappropriate antibiotic prescriptions that are dispensed each year, typically for viral infections.
The next most common prescription is for antidepressants (13 percent), and an equal percentage were taking opioids. Drugs to control high blood pressure came in fourth and vaccines were fifth. The prevalence of antidepressant and opioid use shows that the medical community needs to be vigilant in making sure that people are using drugs to treat illnesses, not mask symptoms.
Mayo also showed that 20 percent of U.S. patients were taking five or more prescription medications. These are often patients with chronic illnesses, likely multiple chronic illnesses, for whom the drugs are vital to keep them out of the hospital and possibly even to keep them alive.
These two new independent studies provide important information about the kind of changes that are needed to advance public health.