U.S. prescription drug spending drops for first time in 58 years

[Auburn85 438]

http://www.cbsnews.c...me-in-58-years/

Americans spent less money on prescription drugs in 2012, the first time in almost six decades U.S. spending on prescription medication has dropped.

The report finds the slip may be indicative of cash-strapped consumers cutting back on their health care services, or the surge of new, inexpensive generic versions of widely used drugs for chronic conditions like high cholesterol.

The new report from IMS Institute for Healthcare Informatics found total spending on medications dropped to $325.8 billion last year from $329.2 billion in 2011. Likewise, average spending per person on medicines fell by $33, to $898 last year, according to the report.

"That's the first time IMS has ever measured the decline in the 58 years we've been monitoring drugs," Michael Kleinrock, director of research development at the institute, told The Associated Press.

IMS, based in Parsippany, N.J., compiles and analyzes data from pharmacies, hospitals, nursing homes, drug wholesalers and other groups to produce its annual report on health care spending trends.

Factors behind last year's drop in drug spending include positive trends such as more use of cheap generic pills and flukes such as a fairly mild cold and flu season in early 2012. But there also was a big negative: people rationing their own health care.

IMS found affordability of health care remains a big problem for many Americans, with growing out-of-pocket costs forcing people to go without needed doctor visits, medicines and other treatments.

For some, that was because they lost jobs or homes during the worst recession in decades. But higher costs also are hitting many employed people who have health insurance.

Employers have been raising health costs for their workers well above the inflation rate, through higher copayments, premiums and deductibles. Many commercial insurance plans now have annual deductibles - the amount a patient must pay before insurance kicks in -- that exceed $1,000, Kleinrock said.

The number of insured people with consumer-directed plans, where patients face very high deductibles and sometimes pay 20 percent of costs after that, has jumped from about 8 percent in 2008 to 19 percent last year. Now many folks insured through their jobs have such plans, not just young, healthy people buying insurance on their own.

"Even patients with insurance are feeling the pinch and have been reducing their use of health care," Kleinrock said.

Recent surveys from Gallup and Consumer Reports also reflect that more Americans are skipping prescriptions and other forms of medical care over costs.

IMS' report notes that out-of-pocket costs, which exclude monthly health plan premiums, are now three times higher than they were five years ago, on average. They're seven times higher for those with consumer-driven plans.

That's one reason the number of doctor visits, planned hospital admissions and outpatient treatments each dipped by a half-percent to 1 percent last year, compared with 2011.

At the same time, the number of patients admitted to hospitals after coming to the emergency department spiked for the second straight year, climbing nearly 6 percent in 2012. That's a sign some people are waiting until they are very sick to seek medical help.

Meanwhile, the number of prescriptions used per person last year edged down just 0.1 percent. At the same time, the percentage of all prescriptions filled with a generic medicine rose from 80 percent in 2011 to 84 percent last year. Nearly three-quarters of prescriptions filled in 2012 cost patients $10 or less in copayments.

A big reason was new generic versions of some of the pharmaceutical industry's biggest-selling drugs of all time: Lipitor for high cholesterol, Plavix for preventing blood clots and strokes, Singulair for allergies and asthma, Diovan for high blood pressure and several others.

Those brand-name drugs all lost patent protection during 2012 or late 2011, enabling generic drug companies to flood the market with copycat pills costing up to 90 percent less.

Those new generics reduced spending on medicines by $28.9 billion last year. That savings was partly offset by the introduction of a big number of breakthrough drugs that are very expensive, drugmakers raising prices on existing medicines and population growth.

Back in 1957, the first year IMS studied, total U.S. drug spending was only $1.9 billion. That's risen each year since, generally climbing more in years when the economy is strong.

For now, IMS is forecasting that overall spending on health care will continue to grow faster than spending on medicines at least through 2017. That's due to factors including the increasing number of elderly patients and those with very expensive chronic conditions such as diabetes, psychiatric disorders, severe heart disease and various cancers.

"The sickest people drive most of our health care spending," Kleinrock said, noting that just over half the total spending by private health insurance plans last year was for just 5 percent of their members.

[Aufan59 168]

Factors behind last year's drop in drug spending include positive trends such as more use of cheap generic pills and flukes such as a fairly mild cold and flu season in early 2012.

This line is telling. There is no pill for the cold or the flu. Yet people still go to the doctor when they have the cold or the flu.

If they stayed at home, they might recover faster, and they might not spread their sickness to others.. This might actually be a GOOD trend....

[ToomersRevenge 284]

Factors behind last year's drop in drug spending include positive trends such as more use of cheap generic pills and flukes such as a fairly mild cold and flu season in early 2012.

This line is telling. There is no pill for the cold or the flu. Yet people still go to the doctor when they have the cold or the flu.

If they stayed at home, they might recover faster, and they might not spread their sickness to others.. This might actually be a GOOD trend....

It's one of the bigger problems doctors have. People don't want to spend an hour in the lobby and 25 bucks to be told they have a cold and sent out the door. They want SOMETHING. So they usually get it, even if it won't do anything for them.

[TexasTiger 14,557]

http://mobile.tamiflu.com/

[Aufan59 168]

It's one of the bigger problems doctors have. People don't want to spend an hour in the lobby and 25 bucks to be told they have a cold and sent out the door. They want SOMETHING. So they usually get it, even if it won't do anything for them.

It confuses me when people demand antibiotics for the cold or flu. Especially with what we know now about the role of antibiotics in our bodies and our immune system. They are only hurting themselves...

[Aufan59 168]

http://mobile.tamiflu.com/

"People, especially children, who have the flu can

develop nervous system problems and abnormal behavior that can lead to

death. During treatment with TAMIFLU, tell your healthcare provider right

away if you or your child have confusion, speech problems, shaky

movements, seizures, or start hearing voices or seeing things that are not

really there (hallucinations)."

Have fun with tamiflu. I'll stick to orange juice and bed rest.

[ToomersRevenge 284]

http://mobile.tamiflu.com/

"People, especially children, who have the flu can

develop nervous system problems and abnormal behavior that can lead to

death. During treatment with TAMIFLU, tell your healthcare provider right

away if you or your child have confusion, speech problems, shaky

movements, seizures, or start hearing voices or seeing things that are not

really there (hallucinations)."

Have fun with tamiflu. I'll stick to orange juice and bed rest.

"People with the flu, particularly children and adolescents, may be at increased risk for seizures, confusion, or abnormal behavior when they first get sick. These events may occur when the flu is not treated or right after starting Tamiflu. These events are uncommon but may lead to accidental injury. Contact a healthcare professional right away if you notice any unusual behavior."

That reads more that those are signs of flu than side effects of tamiflu.

The safety information doesn't list anything to do with neurophysiologic reactions.

Neuropsychiatric Events

Influenza can be associated with a variety of neurologic and behavioral symptoms that can include events such

as hallucinations, delirium, and abnormal behavior, in some cases resulting in fatal outcomes. These events may

occur in the setting of encephalitis or encephalopathy but can occur without obvious severe disease.

There have been postmarketing reports (mostly from Japan) of delirium and abnormal behavior leading to

injury, and in some cases resulting in fatal outcomes, in patients with influenza who were receiving TAMIFLU.

Because these events were reported voluntarily during clinical practice, estimates of frequency cannot be made

but they appear to be uncommon based on TAMIFLU usage data. These events were reported primarily among

pediatric patients and often had an abrupt onset and rapid resolution. The contribution of TAMIFLU to these

events has not been established. Closely monitor patients with influenza for signs of abnormal behavior. If

neuropsychiatric symptoms occur, evaluate the risks and benefits of continuing treatment for each patient.

Sounds like high fever to me. I've certainly not heard of a patient having this poor of results from it.

[TexasTiger 14,557]

http://mobile.tamiflu.com/

"People, especially children, who have the flu can

develop nervous system problems and abnormal behavior that can lead to

death. During treatment with TAMIFLU, tell your healthcare provider right

away if you or your child have confusion, speech problems, shaky

movements, seizures, or start hearing voices or seeing things that are not

really there (hallucinations)."

Have fun with tamiflu. I'll stick to orange juice and bed rest.

Wasn't recommending it, you indicated there was no medication for it.

[alexava 6,977]

It's one of the bigger problems doctors have. People don't want to spend an hour in the lobby and 25 bucks to be told they have a cold and sent out the door. They want SOMETHING. So they usually get it, even if it won't do anything for them.

It confuses me when people demand antibiotics for the cold or flu. Especially with what we know now about the role of antibiotics in our bodies and our immune system. They are only hurting themselves...

I have to keep pounding this into my wifes head. she is one of these people.

[Aufan59 168]

Wasn't recommending it, you indicated there was no medication for it.

You could have mentioned snake oil as well. Both have the same amount of evidence as to their effectiveness.

[ToomersRevenge 284]

Well Tamiflu studies have shown an average reduction in flu symptoms of 1 day in adults and 3.5 days in children with uncomplicated flu. It doesn't seem to do much for complicated flu, but that is more than likely in those who have poorer immune systems so there could be multifactorial reasons for that in play.

[Aufan59 168]

Studies done my the manufacturer, of which they won't release their full reports.

A snake oil salesman has studies that proves the effectiveness of snake oil. However you cannot see the studies.

[ToomersRevenge 284]

I've seen those reports, and I'm not fighting for the efficacy of the drug. I know of people who report feeling better using it, and it has seemed to work but those are anecdotal at best. One of my professors actually worked on a drug almost exactly like Tamiflu, but they were beaten to the punch and their drug was not the golden calf as it were. For his part he said that the testing they were able to do on their drug showed similar promise.

The mechanism of action makes sense, but that also doesn't say much.

[alexava 6,977]

the problem with Tamiflu, or the biggest problem I have is you have to start it like 24hours from the time the symptoms start. I wait longer than that to go to the dr. who runs to the dr as soon as you start feeling bad? unless you're in terrible health the flu is gonna last about 3 or 4 days anyway 5 max.

[alexava 6,977]

I think the reason for drug spending cost reduction is that a lot of popular drugs just went generic in the last year or so.(I didn't read the link)

[ToomersRevenge 284]

the problem with Tamiflu, or the biggest problem I have is you have to start it like 24hours from the time the symptoms start. I wait longer than that to go to the dr. who runs to the dr as soon as you start feeling bad? unless you're in terrible health the flu is gonna last about 3 or 4 days anyway 5 max.

I agree with this. I rarely go to the Dr. and generally get over a flu quite quickly.