Managed Care - March 2009 - (Page 11) MEDICATION MANAGEMENT Metabolic Agents Lead In Total Dollars Spent Medications that lower cholesterol and manage diabetes account for $38.1 billion — the single largest category By Martin Sipkoff recent analysis by the federal Agency for Healthcare Research and Quality (AHRQ) of the spending patterns of adult Americans on prescription drugs found that in 2006, medications affecting metabolism, accounted for $38.1 billion — the single largest category, accounting for 18.3 percent of the $208.1 billion spent on drugs that year. The next four therapeutic classes when ranked by total expense for prescription drugs were cardiovascular agents, central nervous system agents, psychotherapeutic agents, and hormonal agents. Spending for these top five therapeutic classes totaled $130.8 billion and accounted for 62.8 percent of total expenditures on prescription drugs by the adult population in 2006. Although metabolic agents were the largest category, 45.5 percent of the adult population with a prescribed drug expense in 2006 purchased a central nervous system agent, which includes analgesics. The next most popular category was A cardiovascular agents (38.9 percent). Psychotherapeutic agents had the highest average expense per prescription ($91.54), almost double the average expense of the therapeutic class with the lowest average expense, cardiovascular agents ($46.54). The AHRQ report provided no analysis of why these five classifications represented twothirds of the money Americans spent on prescription drugs in 2006 (the latest year for which data based on therapeutic class are available), but analysis by members of the National Health Statistics Group (NHSG) at the Centers for Medicare & Medicaid’s Office of the Actuary point to two concurrent trends which help explain why drugs in these categories are popular: An aging population and the implementation of the Medicare Part D drug benefit. The Census Bureau projects a 147-percent increase in the 65-and-over population between 2000 and 2050. In comparison, the population Top five classifications of prescription drugs in 2006 Using data collected through a household survey of outpatient prescription drug purchasing patterns in 2006, the federal Agency for Healthcare Research and Quality found that the most money was spent on metabolic drugs, but the most popular drugs are central nervous system agents. Analysis of AHRQ data Ranking criteria % of adults having an expense within classification 28.9 38.9 45.5 16.9 29.7 Average expense per prescription in classification $86.90 $46.54 $62.59 $91.54 $48.15 Drug classification 1. 2. 3. 4. 5. Metabolic agents Cardiovascular agents Central nervous system agents Psychotherapeutic agents Hormonal agents $ total expense (billions) $38.1 $33.1 $28.2 $17.5 $14.0 % total expense 18.3 16.0 13.5 8.4 6.8 Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 2006 MARCH 2009 / MANAGED CARE 11
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