Multiple Prescriptions Rise by One-Third, CDC Study Finds
From 1985 to 1999, the average number of drugs prescribed at U.S. doctor visits increased 33% from 1985 to 1999, and Americans over the age of 64 "increased their rate of doctor visits" by more than 20%, to an average of roughly six times year, according to a CDC annual survey of physicians released yesterday (CDC release, 7/17). According to the national survey of doctors conducted by the CDC's National Center for Health Statistics, medications -- "usually a prescription" -- were provided at 501 million of the more than 756 million physician visits in 1999, with the rate of prescribing increasing 33% from 109 drugs per 100 visits in 1985 to 146 drugs per 100 visits in 1999, the Washington Post reports. Examining the use of the 104 medications approved by the FDA between 1997 and 1999. The survey found that the most-prescribed drugs were the ones most "heavily" marketed through direct-to-consumer advertising, with drugs in this category "much more likely" to be in the top one-fifth of new drugs prescribed. The arthritis drugs Vioxx and Celebrex, the asthma drug Singulair and the overactive bladder drug Detrol "accounted for 12% of the estimated $17 billion increase in drug spending that occurred between 1998 and 1999," the Post reports. "[The rise in prescribing] is just a lot more than we would have expected just from the aging of the population," according to Catharine Burt, head of the ambulatory care statistics branch at the National Center for Health Statistics. But Nancy Ostrove, deputy director of the FDA's division of drug marketing, advertising and communication, said it was "impossible" to determine whether advertising -- which the FDA began permitting in 1997 -- has led to the rise in prescriptions or whether both reflect consumer demand that has risen as new and improved medications have become available. The survey also found that prescriptions for antibiotics decreased 14% from 1985 to 1999, "potentially" reducing the incidence of antibiotic resistance (Okie, Washington Post, 7/18).
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The survey also found that while the overall rate for U.S. doctor visits remained steady between 1985 and 1999, seniors sought ambulatory care at a higher rate, "offsetting" a decline among those ages 15-24. Due to population growth and a "larger senior population," the 756.7 million visits in 1999 represented a 19% increase from 1985, with the rate increasing for specialty care but decreasing for general practice physicians. About 60% of visits were to a patient's primary care provider, with more than 33% for "acute problems and another third ... for chronic problems" (CDC release, 7/17). The complete survey is available at
http://www.cdc.gov/nchs/data/ad/ad322.pdf. Note: You will need Adode Acrobat Reader to view the survey.