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.

The Spare Tire of Business Travel

Uh oh!  More bad news for busy pharma executives, physicians and Word on Health bloggers.  A new study published in the April Journal of Occupational and Environmental Medicine has found that people who travel frequently for business increase the rate of poor health and health risk factors, including obesity and high blood pressure.

Travel is a prominent feature of business life in the United States, with an estimated 405 million long-distance business trips taken in 2009. While there is a large body of literature on health risks associated with business travel, this is almost exclusively focused on infectious diseases and the risks of deep vein thrombosis and pulmonary embolism associated with long-distance air travel.

In this latest study Catherine A. Richards, MPH, and Andrew G. Rundle, DrPH, of the Mailman School of Public Health at Columbia University compared health risks for employees at different levels of business travel. They used data on more than 13,000 employees from a corporate wellness program. Close to 80% of the employees travelled at least one night per month. Nearly 1% were “extensive travellers” which they defined as those who are on the road more than 20 nights per month.Employees who did not travel at all were actually a less-healthy group. Compared to light travellers (1-6 nights per month), non-travellers were about 60% more likely to rate their health as fair to poor.   However, this may reflect a “healthy worker effect”, with employees who have health problems being less likely to travel, suggest the authors.

Otherwise, rates of less-than-good health increased along with nights of travel. Extensive travellers were a staggering 260% more likely to rate their health as fair to poor, compared to light travellers.

Other health risk factors showed similar patterns: obesity was 33% more likely for non-travellers and 92% more likely for extensive travellers.
The same two groups were also more likely to have high blood pressure and elevated cholesterol levels.

Although business travel is often equated with long airline flights, relatively short business trips in personal cars are much more common.   Several factors could contribute to health risks in frequent business travellers, such poor sleep, fattening foods, increased alcohol consumption and long periods of inactivity.

The authors of the study suggest a number of interesting solutions to the problem such as employee education programs on the association between business travel and health and strategies to improve diet and activity while traveling.  They also recommend that companies who reimburses employees for meals while traveling, tie reimbursement rates to dietary quality. A “stick” approach might be to reimburse high–energy density food meals at a below cost rate, while a “carrot” approach might be to reimburse healthy meals at an above cost rate.

Additionally, companies that have arrangements with particular hotel chains could make having a gym part of the criteria for selecting a hotel chain and employees should be given time and perhaps financial incentives to exercise while traveling.

How do you cope with life on the road?  Please share your travel tips with us.

Is prescription drug spending sky-rocketing out of control?

Are prescription costs raising your blood pressure?

According to the latest news and numbers from the Agency for Healthcare Research and Quality (AHRQ) they may well be.  Figures, just released, show that insurers and consumers spent $52.2 billion on prescription drugs for outpatient treatment of metabolic conditions such as diabetes, hypertension, high-cholesterol, obesity and thyroid disease.

The four remaining top therapeutic classes of outpatient prescription drugs were:

• Central Nervous System ($35 billion)
  • i.e. chronic pain, epilepsy, Parkinson’s Disease
• Cardiovascular drugs ($29 billion)
  • i.e. calcium channel blockers and diuretics
• Antacids, & other medicines for gastrointestinal conditions ($20 billion)
• Antidepressants, antipsychotics & other psychotherapeutic drugs ($20 billion)

In 2008, purchases of metabolic drugs by adults age 18 and older accounted for 22% of the total $233 billion spent to buy prescription drugs.

To put this number in perspective, $223 billion would buy you either 1,000 brand new 747 jumbo jets; 137 new space shuttles or 495 space shuttle missions!