The Growing Cost of Aging

With the election looming, we’ve heard a lot of rhetoric about healthcare. Rising costs, limited access, reforming Medicare…the list goes on and on.  Whatever happens on November 6, it seems the American public has already spoken. According to new research just unveiled at the American Public Health Association’s Annual Meeting, the cost of lifestyle drugs now exceeds the cost for medications used to treat chronic disease.

The research suggests that medicines used to treat conditions considered a normal part of aging, including those related to hormone replacement therapy, sexual dysfunction, menopause, aging skin, hair loss and mental alertness, are becoming so popular that they now rank third.  Only diabetes and high cholesterol have a greater cost impact among commercially insured patients.

Researchers at Express Scripts in St. Louis looked at trends in prescriptions filled for aging medications.  In 2011 alone, the cost per person for aging medications ($73.30) was 16% greater than the amount spent on both high blood pressure and heart disease medications ($62.80).  The cost for diabetes medications was $81.12 and high cholesterol medications was $78.38.

The research found that among these insured individuals use of drugs to treat the physical impact associated with normal aging was up 18.5% and costs increased nearly 46% from 2006 to 2011. Increased use of these drugs was even more pronounced for the Medicare population (age 65+), up 32% from 2007 to 2011. The largest utilization jump among Medicare beneficiaries was from 2010 to 2011, up more than 13% and outpacing increases in the use of drugs for diabetes, high cholesterol and high blood pressure combined.

“At a time when people are forgoing care due to rising health costs, this study reveals a growing trend on where the public is placing its healthcare dollars,” said Reethi Iyengar, PhD, researcher at Express Scripts.  “Continued monitoring and potential management may be warranted for this category of medications.”

While there is no doubt that pharmaceutical advances and greater awareness have improved the quality of life for many aging Americans what was not known, until now, is the significant cost associated with treating these conditions. Couple that with the proliferation of people living longer and it’s clear that managing the trend and spend from treating conditions associated with aging will become increasingly important.

The United States is in the midst of a profound demographic change, with the number of elderly people projected to reach nearly 20% of the entire population by 2030, up from less than 13% in 2009. This increase will continue to drive both use and costs of medications to treat the natural conditions of aging.

But the problem may be even bigger. The greatest growth in cost per insured was seen among the 45 to 54 age group – up almost 21% over the last five-years. And because the study only analyzed prescription medications it may have underestimated the total costs of aging treatments, which include a variety of over-the-counter medications, cosmetic treatments and surgery.

Seems getting old hurts not only our bodies, but our wallets and the economy too.

Botox, Brotox & Bladders

When someone mentions Botox injections, you probably think of Hollywood actresses with too perfect faces or wealthy housewives desperately trying to turn back time. Yes, we know it’s becoming more main stream, so maybe you’re also thinking about your own appointment for “shots” or maybe even “BroTox”. What we’re pretty sure you’re not thinking about is – incontinence. However, that’s exactly its newest use. Recently, the FDA approved using the injections to help patients with neurological conditions (such as multiple sclerosis or spinal cord injury) who suffer from either incontinence, or an overactive bladder. Neurologic conditions can cause miscommunication between the bladder and the brain.  As a result, the bladder muscle can become overactive, increasing the pressure in the bladder and decreasing the volume of urine the bladder can hold. This can lead to frequent, unexpected urine leakage, or urinary incontinence. Botox works by paralyzing bladder muscles, thus preventing the contractions that cause urgency or leakage. Although medications and behavioral modifications are treatment options, many patients, especially the elderly, do not respond to these methods and need a more aggressive approach. “About 80 percent of patients with neurological conditions, such as spinal cord injuries, Parkinson’s disease and multiple sclerosis, see improvement after about a week, and the results can last four to nine months,” says Charles Nager, MD, co-director of the UC San Diego Women’s Pelvic Medicine Center at UC San Diego Health System. Incontinence is the seventh condition, including chronic migraines, upper limb spasticity and underarm sweating, that Botox has been approved to treat since it first arrived on the market in 2002. The outpatient procedure uses a local numbing gel, followed by 15 -20 injections in different areas of the bladder muscle. “It can really be life changing for someone with severe incontinence issues,” said Nager. Want to share your Botox stories with SRxA’s Word on Health?  We’d love to hear from you.