Behind the Slowdown in Prescription-Drug Use

Jun 7, 2013
Baby boomer demographics and economic trends dampen utilization of prescription drugs. Learn more ...
  • Adults

Use of prescription drugs has leveled off in recent years among patients covered by private health insurance.

trend prescription drug utilization growth

Healthcare experts might have expected a continuation of the steady increases prior to 2007, especially in light of the aging U.S. population, the rising prevalence of obesity and related conditions, more choices in lower-cost generic medications and the arrival of new drugs to treat chronic conditions.

Study Determines Factors Behind Slowdown

A recent Express Scripts study to determine the major factors behind this counterintuitive development came up with three explanations:

The portion of labor union members among Americans covered by private health insurance has steadily declined. We believe that labor union participation reflects overall employee cost-share and economic conditions related to the economic recession. As economic conditions grew difficult and employees had to pay higher shares of their healthcare costs, including prescription-drug costs, utilization waned.

Baby boomers started becoming eligible for Medicare and were no longer covered by private insurance. This shifts utilization away from commercially insured members.

Following the baby boomer population bubble, fewer people enter middle age each year, when the use of chronic medication becomes more common.

line graph labor union demographics

We presented the research recently at the annual meeting of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) in New Orleans. The research drew on Express Scripts claims data and publicly available information from 1997 to 2011.

The period of leveling off in utilization began in approximately 2007, which corresponds to the beginning of an economic recession and the slow recovery that started in 2009.

The study considered other possible explanations – some related to the economy – but none was statistically significant in predicting change in utilization. Those factors included housing price indices, physician office visits per 100 persons, direct-to-consumer advertising spend, movements of high-volume therapy classes to over-the-counter status, and prevalence of obesity and diabetes.

Upward changes in utilization require both new patients and starting new treatments. With the majority of baby boomers already using multiple therapy classes, there are limited opportunities to increase utilization among that cohort. Succeeding generations are less populous and may be leading healthier lifestyles, ultimately requiring fewer prescription drugs.

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