Benjamin Franklin said, “In this world nothing can be certain, except death and taxes.” With the increase in the use of prescriptions, we can likely add “medications” to this famous quote by Franklin. A recent study published in the Journal of American Medical Association evaluated the trends in prescription use in American adults. The verdict, as expected, is an overall increase in prescription use. Just as the percent of adult prescription users increases, so does the use of multiple prescriptions (defined as “polypharmacy,” the use of 5 or more medications simultaneously)—from 8% of the adult population in 2000 up to 15% in 2012. The use of multiple prescriptions is particularly prevalent in those over 65 years of age, with over 39% of this demographic on polypharmacy.
With the increase in polypharmacy comes the subsequent need for medication management. For instance, an individual might use one medication to treat a side effect caused by another medication rather than change or discontinue the initial medication. Additionally, medications that are meant for short-term use become chronic medications (i.e. sedatives). While the continued discovery of new drugs has improved the lives of many Americans, proper use of these medications requires appropriate selection, dosing, and monitoring. This is especially true as we age because the effects of drugs on the body and the body’s effect on drugs is altered as with the change in metabolism.
The use of medication can indeed improve patient care, helping to avoid hospitalizations and reducing the overall cost of insurance and co-pays for patients. However, there have been recent concerns regarding the often exorbitant prices for newer therapies. It’s not unusual to see prices in the tens of thousands of dollars for new treatments, such as those for cancer or hepatitis C. Even chronic medications that might serve as a lifeline, such as cholesterol-lowering and diabetic medications, can completely deplete the average person’s bank account. A new report by STAT-Harvard indicates that more than 75% of people surveyed believe that prescription prices are too high and that the government should do something to regulate them.
We are essentially facing a perfect storm: the drastic increase in the number of people using medications, an increase in the number of medications each person uses on average, and the rising drug prices. Judicious and cost-effective usage is necessary to ensure that every patient can get the right medication at an affordable price. In a sense, like death and taxes, prescription medications are inevitable. Ultimately, it’s how we manage these medications that is important.
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