Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

The exploding cost of prescription drugs

Homayoun L. Daneschvar, MD
Meds
February 25, 2017
Share
Tweet
Share

The amount of prescribed medications and the number of individuals taking them are increasing rapidly. The share of Americans taking one or more prescription drugs has risen among all age groups. According to the IMS Health Study, the total spending on prescription drugs in the U.S.  reached $310 billion in 2015. This is almost three times more than total drug expenditures in the year 2000. It is forecasted that the U.S. spending on medicine will reach $370 to $400 billion in 2020. Moreover, several drug makers have notably increased their drug prices in recent years.

Meanwhile, 76-year-old Ethel must choose between groceries or heart and diabetes medications this month because social security benefits simply can’t keep up with the rising cost of medications. Over-consumption in the health care industry has caused necessary prescription drug costs to skyrocket, leaving individuals with serious chronic conditions financially destitute. We need a solution.

There are several reasons for this significant increase in medication usage in our society.

One obvious reason for this change is technological and scientific advances. We know more now than we did 10 or 20 years ago, and our ability to treat many conditions has improved. For example, progress in genetic research and the translation of laboratory knowledge into effective treatments has been fascinating and promising. Due to these advances, we have increased access to more effective and more expensive treatments, which allow patients to live longer. We are witnessing the dilemma created by these trends, as illustrated by the latest hepatitis C medications. These medications are effective and have fewer side effects than previous medications but are nearly unaffordable. Similar challenges certainly will be a part of the future of the practice of medicine.

Relative longevity is one of the positive outcomes of improved health care quality. This increased longevity leads to prescription volume growth and a higher cost of care. Individuals older than 65 comprise about 12 percent of the U.S. population, but they consume about 33 percent of prescribed medications. More than 80 percent of the older population is on at least one prescription drug daily and according to one analysis published in the Journal of American Medical Association the number of individuals on 5 or more prescription drugs increased from an estimated 8.2 percent in 1999 to 2000 to 15 percent in 2011 to 2012.

In the past few years, the initiation and expansion of the Affordable Care Act has been one of the drivers of prescription drug growth by adding millions of new patients to the pool, many of whom require prescription drug treatment.

If we accept that scientific progress can’t and shouldn’t be stopped, that improved longevity of the population is a positive outcome, then we must answer a key question: How can we afford and sustain this development in the long term without going bankrupt?

As a society, we need to concentrate on processes and behaviors that we can change or eliminate. Reducing the expenditure on medicines can be achieved by lowering the cost of acquiring the medicines and at the same time decreasing the demand.

There is a mindset in our society and health care system that we must “fix” anything that appears to be wrong. It fails to distinguish whether what we are trying to fix is a natural process or truly a disease. We want all body and mind-related problems “normalized” as quickly as possible without spending too much time or effort. This unrealistic expectation drives large numbers of people to choose medication over conservative management or a wait-and-watch approach. The desire to treat upper respiratory infections with antibiotics and asymptomatic testosterone deficiency with medications are only two examples of this deeply rooted trend in our society.

Another major shortcoming that increases medication usage in our society is entrenched in the medical education system which has an emphasis on using medications to treat disease. Few medical schools teach students about other options, such as nutrition, behavioral changes or a more comprehensive approach to disease management. Our medical practitioners learn how and when to start a medication, but they have difficulty in recognizing the best time and method for discontinuing a medication. It is a well-known phenomenon that starting a medication is a much easier task than stopping the same medication.

Our practice-related guidelines focus mainly on medication usage; these guidelines usually include only very general and broad suggestions for the conservative management of a disease, which lack any specificity and practicality. More importantly, our medical education is based on treating disease and not preventing it.

It is imperative that we change how our society manages disease if we want to afford high-quality medications for many years to come. We need to improve public health education and educate patients that aggressive and immediate treatments are, for many conditions, not necessarily better than conservative management. We need to educate the public that we can’t and shouldn’t try to “fix” a natural process and that sometimes, aggressive treatment might cause more harm than good in the long term. We need to promote managing the source of the problem, rather than the symptoms and comprehensive management of a condition that might require more tools than medication alone.

All of the above steps require a well thought out approach. It is true that we have to reduce the amount of prescription drugs. However, we should achieve this goal not by vilifying the medications or adherence to them, but by using them wisely.

ADVERTISEMENT

Homayoun L. Daneschvar is an internal medicine physician.

Image credit: Shutterstock.com

Prev

Success is not congratulated as easily as failure is shamed

February 25, 2017 Kevin 3
…
Next

Physician coaching and retreats are innovative ways to fight burnout

February 25, 2017 Kevin 9
…

Tagged as: Medications

Post navigation

< Previous Post
Success is not congratulated as easily as failure is shamed
Next Post >
Physician coaching and retreats are innovative ways to fight burnout

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

Related Posts

  • The cost of drugs confounds this gastroenterologist

    Michael Kirsch, MD
  • Generics aren’t going to help the cost of chemotherapy drugs

    Peter Ubel, MD
  • Prescription drugs are killing students and the educational system

    Yasir Khan, MD
  • A call for cost transparency

    Mukul Mehra, MD
  • The cost of avoiding cost: a medical student’s perspective

    Palak Patel
  • Is this cost-saving Medicare proposal doomed?

    Martha Rosenberg

More in Meds

  • Why retail pharmacies are the future of diverse clinical trials

    Shelli Pavone
  • Why does rifaximin cost 95 percent more in the U.S. than in Asia?

    Jai Kumar, MD, Brian Nohomovich, DO, PhD and Leonid Shamban, DO
  • A world without antidepressants: What could possibly go wrong?

    Tomi Mitchell, MD
  • The truth about GLP-1 medications for weight loss: What every patient should know

    Nisha Kuruvadi, DO
  • The hidden bias in how we treat chronic pain

    Richard A. Lawhern, PhD
  • Biologics are not small molecules: the case for pre-allergy testing in an era of immune-based therapies

    Robert Trent
  • Most Popular

  • Past Week

    • 2 hours to decide my future: How the SOAP residency match traps future doctors

      Nicolette V. S. Sewall, MD, MPH | Education
    • Why removing fluoride from water is a public health disaster

      Steven J. Katz, DDS | Conditions
    • When did we start treating our lives like trauma?

      Maureen Gibbons, MD | Physician
    • In a fractured world, Brian Wilson’s message still heals

      Arthur Lazarus, MD, MBA | Physician
    • When your dream job becomes a nightmare [PODCAST]

      The Podcast by KevinMD | Podcast
    • How doctors took back control from hospital executives

      Gene Uzawa Dorio, MD | Physician
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • Why shared decision-making in medicine often fails

      M. Bennet Broner, PhD | Conditions
    • My journey from misdiagnosis to living fully with APBD

      Jeff Cooper | Conditions
    • Why we fear being forgotten more than death itself

      Patrick Hudson, MD | Physician
  • Recent Posts

    • When your dream job becomes a nightmare [PODCAST]

      The Podcast by KevinMD | Podcast
    • Finding healing in narrative medicine: When words replace silence

      Michele Luckenbaugh | Conditions
    • Why coaching is not a substitute for psychotherapy

      Maire Daugharty, MD | Conditions
    • When the white coats become gatekeepers: How a quiet cartel strangles America’s health

      Anonymous | Physician
    • Why doctors stay silent about preventable harm

      Jenny Shields, PhD | Conditions
    • Why interoperability is key to achieving the quintuple aim in health care

      Steven Lane, MD | Tech

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 1 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • 2 hours to decide my future: How the SOAP residency match traps future doctors

      Nicolette V. S. Sewall, MD, MPH | Education
    • Why removing fluoride from water is a public health disaster

      Steven J. Katz, DDS | Conditions
    • When did we start treating our lives like trauma?

      Maureen Gibbons, MD | Physician
    • In a fractured world, Brian Wilson’s message still heals

      Arthur Lazarus, MD, MBA | Physician
    • When your dream job becomes a nightmare [PODCAST]

      The Podcast by KevinMD | Podcast
    • How doctors took back control from hospital executives

      Gene Uzawa Dorio, MD | Physician
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • Why shared decision-making in medicine often fails

      M. Bennet Broner, PhD | Conditions
    • My journey from misdiagnosis to living fully with APBD

      Jeff Cooper | Conditions
    • Why we fear being forgotten more than death itself

      Patrick Hudson, MD | Physician
  • Recent Posts

    • When your dream job becomes a nightmare [PODCAST]

      The Podcast by KevinMD | Podcast
    • Finding healing in narrative medicine: When words replace silence

      Michele Luckenbaugh | Conditions
    • Why coaching is not a substitute for psychotherapy

      Maire Daugharty, MD | Conditions
    • When the white coats become gatekeepers: How a quiet cartel strangles America’s health

      Anonymous | Physician
    • Why doctors stay silent about preventable harm

      Jenny Shields, PhD | Conditions
    • Why interoperability is key to achieving the quintuple aim in health care

      Steven Lane, MD | Tech

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

The exploding cost of prescription drugs
1 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...