Managed Care - March 2009 - (Page 10) NEWS AND COMMENTARY More Young Adults Using Sleep Aids The use of prescription sleep aids by 18- to 24-year olds nearly tripled between 1998 and 2006, according to medical and drug claims data from the Thomson Reuters MarketScan Research databases. During that period, the average length of time sleep aids were used by adults under age 45 increased by more than 40 percent — rising from 64 days in 1998 to 93 days in 2006. What’s the cause of these sleepless nights? “Insomnia appears to be causing larger numbers of young adults to turn to prescription sleep aids. They tend to use them for longer periods of time,” says William Marder, PhD, senior vice president and general manager of the Thomson Reuters health care business. The most dramatic increase was in the 18-to-24 age population, whose prevalence of use increased from 599 users per 100,000 in 1998 to 1,524 per 100,000 in 2006. For those 24 to 34, use almost doubled from 1,372 to 2,528 per 100,000. Personal health spending, by condition f all diagnostic categories, circulation has by far the largest expenditures, accounting for 17 percent of expenditures among the diagnostic categories in 2005. The next seven expenditures account for about half of the total and range from mental disorders (9 percent) to nervous system disorders (6 percent). Findings are in the February issue of Health Affairs. The study provides annual estimates from 1996 through 2005 for 32 conditions in 13 all-inclusive diagnostic categories. O Headlines On Deadline Just more than half of 489 large U.S. companies now offer their employees a consumer-directed health plan (CDHP), up from 47 percent in 2008, according to a new survey issued by Watson Wyatt and the National Business Group on Health. Another 8 percent are expected to adopt a CDHP by 2010. Companies with at least half of their employees enrolled in a CDHP have two-year cost increases that are 25 percent lower than non-CDHP health plan sponsors (4.6 percent vs. 6.1 percent) The proportion of children and working-age Americans who went without a prescription drug because of cost concerns jumped to 1 in 7 in 2007, up from 1 in 10 in 2003, according to a national study released by the Center for Studying Health System Change. The 2007 Tracking Survey identified rising prescription drug costs and less generous drug coverage as major contributors. . . .The credit rating organization A.M. Best forecasts a negative outlook for health insurers in 2009. But earnings are not a cause for concern (earnings remain favorable) — it’s the uncertainty of the economic environment. Recession, reform, and competition will affect enrollment and investment income. Declining enrollment, pressure from employers for lower premium rates, and competition in the commercial market will depress profit margins, according to the 2009 special report. — Tony Berberabe Spending by year ($ billions) 250 Circulatory system 200 Other categories 150 Mental disorders Musculoskeletal Injury and poisoning Digestive Neoplasms Respiratory Prevention/exams Nervous system 50 Genitourinary Endocrine 100 0 1996 2000 2005 Source: Roehrig C, Miller G, Lake C, Bryant J. National health spending by medical condition, 1996–2005. Health Affairs 2008;2:358–367 10 MANAGED CARE / MARCH 2009
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