Managed Healthcare Executive - October 2008 - (Page 28)

{ PHARMACY BEST PRACTICES } Children face growing risk of chronic adult conditions Guidelines and clinical trials for adult medication use in children few and far between, so try lifestyle changes rst BY MARI EDLIN Mari Edlin is a frequent contributor to MANAGED HEALTHCARE EXECUTIVE. She is based in Sonoma, Calif. 28 OCTOBER 2008 OES IT MAKE SENSE TO TREAT children for conditions, such as high cholesterol, type 2 diabetes and hypertension, with drugs that have only been approved for adults? If the potential bene t to the child is outweighed by the risk of harm or adverse events, then it makes sense, experts say. “This determination would certainly have to be made on a case-by-case basis,” says Mes n Tegenu, president of PerformRx, a pharmacy bene ts manager (PBM) located in Philadelphia. According to a 2007 study conducted by IMS in 2007, more than 40% of children between the ages of six and 14 take prescription medications, including D those for asthma, allergy, ADHD, type I diabetes and other conditions. Studies by Medco Health Solutions and Express-Scripts illustrate a growth in the use of medications in children to treat high cholesterol and hypertension. Research by Medco indicates that about 1.2 million children in the United States are taking adult medications for type 2 diabetes, sleep and gastrointestinal disorders. The type 2 diabetes drugs showed the greatest increase over a seven-year period—more than 150%—with use by girls tripling. High blood pressure and cholesterol-lowering medications increased by 18% and 12%, respectively, for children 19 and under. Lon Castle, MD, senior director, Department of Medical and Analytical Affairs for Medco, is more concerned about the growing trend toward adult diseases in children, than the use of medications to treat those conditions. “Many drugs tested for adults are appropriate for children, so I don’t think the health of children is jeopardized by these drugs,” he says, “but I am concerned that our lifestyle is creating conditions children shouldn’t face until at least their 40s. This extra need for healthcare will overburden our system.” Express Scripts conducted research from 2002 to 2005 in children ages ve to 19 and found that there was an increase across every chronic medication class examined. Ed Weisbart, MD, chief medical o cer, medical a airs for Express-Scripts, considers the availability of some of these drugs to be a double-edged sword, especially for treating conditions associated with obesity. Medioimages/Photodisc

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Managed Healthcare Executive - October 2008 For Your Benefit Editorial Advisors Contents News Analysis State Report Politics &�Policy Healthcare Reform Trends in 2009 Cost Control Strategies Predicted Premium Increase Top Challenges in 2009 IT System Integration Technology Innovation Disease Management Health Management Pharmacy Best Practices Technology Desktop Resource Ad/Edit Index Managed Care Outlook Statement of Ownership

Managed Healthcare Executive - October 2008

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