Attack Continues on Pharma Prices

In case anyone missed the recent wave of studies and reports documenting rising expenditures on medicines, Families USA weighed in with an analysis that further documents rising prices of medicines prescribed for the elderly. The report surfaced just before the US House of Representatives voted on a Medicare pharmacy benefit and was timed to influence that debate. (See " Washington Report,")

In analyzing cost increases for the 50 medicines most used by seniors, the report found that prices for many of those products rose much faster than inflation and that the cost increases of brand-name therapies outpaced generics. That creates huge problems for the many seniors living on fixed incomes, observed Families USA executive director Ron Pollack, who urged consumers to write members of Congress about the importance of adding a prescription drug benefit to Medicare. Manufacturers countered that retail pharmacy prices vary widely and provide a faulty measure of medicines' true costs. They also urged consumers to shop around.

Researchers at the Centers for Disease Control and Prevention (CDC) link spending hikes to a noticeable increase in physician prescribing. An analysis of patient data collected by the CDC's National Center for Health Statistics between 1985 and 1999 found a 34 percent jump in physicians' prescribing rates. Another finding is a big jump in the number of physicians who prescribe multiple medicines per patient visit. If those trends continue, spending on pharmaceuticals will double in the next five years, according to the report, published in the July/August 2002 issue of Health Affairs.

Study author Catharine Burt ascribes the boost in prescribing primarily to increases in patient age and the number of medical conditions per patient. Other factors include expanded pharmacy coverage, rising biomedical R&D, faster FDA approvals, and increased pharma marketing to physicians and consumers. Most of the prescribing increase occurred in a few drug classes: antidepressants, hyperlipidemia drugs, ACE inhibitors, antihistamines, and calcium channel blockers. (See chart.) The only drop was in antimicrobial agents. Psychiatrists recorded the largest rise in "drug mention" rates (during patient visits), while surgeons, cardiologists, and dermatologists' drug mentions declined.

Top-detailed theraputic classes accounted for...