The high cost of seniors' soaring Rx drug use
If you had to guess which age group among Americans takes the most prescription drugs, you'd most likely go with the oldest. And you'd be right.
A recent study found that almost half (47 percent) of Americans age 75 and older took five or more prescription drugs in 2011, nearly double the 24 percent that did so in 1999, just 12 years earlier. The comparable percentage for Americans 65 to 74 also increased significantly -- from 23 percent in 1999 to 33 percent in 2011.
These results were reported by the Sightlines Project, a recent landmark study conducted by the Stanford Center on Longevity (SCL), which looked at steps individuals and society can take to contribute to overall well-being and longevity. [Full disclosure: The author works at the Stanford Center on Longevity and participated in the Sightlines Project.]
The prescription drug use results have mixed interpretations. On the one hand, the trend is inevitable given the increase in chronic conditions medications can manage. Prescription drugs could be keeping these older Americans alive and living independently.
On the other hand, research indicates that taking this number of medications increases the risks for confusion, dizziness and falls, as well as unanticipated drug interactions. And medical science just doesn't know the consequences of taking several prescription drugs for 10, 20 or 30 years.
To help counteract that lack of knowledge, SCL's Sightlines report calls for more research into the risks vs. benefits of increased, long-term prescription drug use.
The trend began before the implementation of Medicare Part D coverage for prescription drugs, so increased coverage is unlikely to be a significant cause. However, many suspect that increased advertising -- to the tune of $5.2 billion annually -- by pharmaceutical companies is playing a role. So, in late 2015 the American Medical Association called for a ban on direct-to-consumer advertising of prescription drugs and medical devices.
The trend has significant financial ramifications, both for individuals and society. For individuals, co-payments for multiple prescriptions can add up to hundreds of dollars each year and thousands over many years. On a societal level, in 2014 Medicare Part D spent $78 billion on prescription drugs for participants. Of this amount, premiums paid by retirees for Part D amounted to about $11 billion, with the remainder financed by federal and state governments.
Once again, however, there's a mixed message on whether the high costs are worth it. For instance, it could be that some prescription drugs prevent more expensive hospital stays, which Medicare also pays for.
Seniors often use these drugs to address chronic conditions such as high blood pressure, high cholesterol, and diabetes -- which can all be potentially mitigated or prevented through modifications in nutrition, exercise and stress management. But according to the Sightlines report, only about one-quarter of Americans eat the recommended five portions of fruits and vegetables each day, less than half exercise for 150 minutes or more each week, and four in 10 don't get the recommended seven hours of sleep each night.
Almost 60 percent of Americans' daily calories come from ultraprocessed foods that are often laden with sugar, sodium and additives. As a result of all these trends, more than one in three Americans under age 75 is obese.
If many Americans made positive changes in lifestyle, we'd reduce societal costs for Medicare and decrease price pressure on prescription drugs. And if individuals can reduce their prescription drug use through these lifestyle choices, they could potentially save hundreds of dollars each year and reduce vulnerability to drug interactions. They wouldn't be part of the vast experiment society is conducting to see what happens when many people take multiple prescription drugs for long periods of time.
If these results interest you, see your doctor about a medically supervised lifestyle program to reduce your use of lifetime prescription drugs.