More than 30 organizations representing consumers, union workers, health care providers and employers, announced on May 10th the findings of a study of 1.4 million continuously insured people, their use of prescription drugs and the resulting costs over the last three years.
According to the Rx Health Value study, annualized cost increases for the population surveyed were 28.8% (24.4% when adjusted for study group’s aging) for each of the three years studied (1996-1999), a higher rate of increase than reported by any previous study. Dan Wolfson, ACHP’s president and CEO told reporters a news conference at the National Press Club in Washington that the results of this unprecedented study show that, “…there is a compelling need for independent data regarding the comparative value of prescription drugs.”
RxHealthValue members asked the Schneider Institute for Health Policy at Brandeis University to undertake the study using the extensive data base of PCS Health Systems, a national pharmacy benefit management organization and a Center member. The study will be described Thursday at the annual meeting of the Council on the Economic Impact of Health System Change at Princeton University in New Jersey. Stanley Wallack, Ph.D., Executive Director of the Schneider Institute and principal investigator for the study, said “This is the first research that documents the actual use of prescription drugs by an insured population over time and allows us to identify some never reported trends. These findings are significant in that we now know that price isn’t the single factor driving escalating prescription drug expenditures. Americans are using more prescriptions, at younger ages and for more conditions and are substituting newer, more costly medications for more established products. This increase in cost per treatment day, coupled with the price and the substitution effect in a stable population of insured individuals has been the major contributor to the 28.8% annual increase during this period.”
The Brandeis researchers determined that the increase in the number of people taking prescription drugs has been greatest among the 45-65 year-olds. The growth in prescriptions per person has been greatest for the 65 and older age group. New medications account for more than one third of the increase in total expenditures during this period. Additionally, focusing on three specific drug classes – Proton Pump Inhibitors (GI agents); Cox-2 and NSAIDs (anti-arthritics) and Statins (cholesterol-lowering drugs), they found patients not only substituting new drugs for old ones, but also beginning drug therapy for conditions not previously treated with prescription medications.
With this increase in use and costs of prescription drugs, little objective comparative information is available. “Consumers, clinicians, payers and policy makers are at a distinct disadvantage,” said John Golenski, Acting Executive Director of RxHealthValue. “Determining value has been almost impossible in the absence of an independent source of data and analysis.” Golenski said RxHealthValue has been created to provide that kind of information. Since RxHealthValue’s primary mission is the creation and dissemination of useful information for making value-based judgments, the Center’s members made three initial recommendations:
- Establishment of independent research institutes to determine the clinical and economic value of prescription drugs;
- Development of national standards for risk/benefit information disclosure in direct-to-consumer advertising of prescription medications; and,
- Improved post-marketing monitoring of adverse drug reactions, especially of “fast track” drugs, by the FDA.
During the next several months, RxHealthValue will be sponsoring additional research on prescription drug value and releasing additional recommendations to enhance and support value-based decisions.