California Healthline Daily Edition

Summaries of health policy coverage from major news organizations

U.S. Residents Cutting Back on Doctor Visits, Prescription Drugs

U.S. residents went to the doctor less and received fewer prescription drugs in 2011, according to a report by the IMS Institute for Healthcare Informatics, the New York Times reports.

The report found that physician visits declined by 4.7% from 2010 to 2011. It also found that 1.1% fewer prescription drugs were issued to patients in 2011 than in 2010.

The decrease in prescription drugs was driven in large part by U.S. residents ages 65 and older, whose prescription drug use declined by 3.1% from 2010 to 2011. That decrease in utilization came despite the average prescription drug copayment under Medicare Part D declining from $25.97 in 2010 to $23.31 in 2011.

The decline in copayments -- which the report attributes to subsidies under the federal health reform law -- resulted in beneficiaries enrolled in Part D spending less out of pocket, from $11.5 billion in 2010 to $9.7 billion in 2011, according to the report.

Other Findings

The study also found that young adults ages 19 to 25 were issued 2% more prescription drugs in 2011 than in 2010. The largest increases for the group were for antidepressants and drugs to treat attention deficit hyperactivity disorder. The researchers said the change was caused by the overhaul allowing young adults up to age 26 to remain on their parents' health plans.

In addition, the report found that emergency department visits increased by 7.4% from 2010 to 2011. The study authors attributed the increase in ED visits to the loss of insurance coverage because of long-term unemployment.

The report also found that drugmakers introduced 34 new drugs -- the most in a decade (Thomas, New York Times, 4/4).

Patients Shifting Toward Less Utilization

The U.S. public might be shifting its views on whether more utilization of health care services leads to better care, after believing so for decades, the New York Times' "Well" reports.

Recent studies indicate that U.S. residents are abandoning the "more is better" attitude on health care. The Cochrane Collaboration in March released a review of more than 20,000 patients using "decision aids," which explain potential benefits, harms and uncertainties. The studies found that patients using the tools more often declined procedures like surgery and cancer screening, and opted for more conservative interventions.

Michael Barry, president of the Informed Medical Decisions Foundation, said, "People are more receptive to conversations about medical interventions having both pros and cons." Barry said that patients traditionally thought "newer and more aggressive interventions" to be better, but now, "[w]hen patients are fully informed, they tend to be more conservative."

Barry noted that several books on the dangers of unnecessary treatment and media coverage on the topic could be driving the change in attitude. He added that news coverage on fines paid by drugmakers, the overuse of radiation, medical device recalls and increasing numbers of deaths linked to prescription drugs all could have an effect on the trend. "Even once-sacred interventions," such as cancer screening, are more scrutinized as researchers realize potential risks and the tests' limited benefits, according to "Well."

The medical community increasingly is acknowledging that many tests and procedures are unnecessary, according to "Well." Health care providers and experts this month in Boston will hold the first major medical conference to focus on the risks of unnecessary care (Newman, "Well," New York Times, 4/4).

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