Medications for Normal Aging Driving Up Prescription Drug Expenses

The cost burden for optional drugs parallels that of life-threatening conditions

More is spent on optional medications, such as drugs for erectile dysfunction and urinary symptoms, than on drugs needed for common diseases. (Photo: Dorling Kindersley/Getty Images)

Shari Roan is an award-winning health writer based in Southern California.

People talk a lot these days about the cost of prescription medications. The issue has been at the heart of discussions about healthcare reform and funding for Medicare. But what if many of the medications that are driving high healthcare costs weren't even necessary?

That question may become the focus of attention based on new statistics released Tuesday which show the cost impact of optional medications used for conditions that, traditionally, have been considered a normal part of aging —such as sexual dysfunction, menopause, urinary symptoms and insomnia.

Between 2007 and 2011, utilization of drugs to treat these conditions rose 32 percent among Medicare beneficiaries and 8.5 percent among people who have private insurance. These age-related medications are now so popular they rank third in cost impact only behind diabetes and cholesterol medications among commercially insured patients.

"The trend we observed was surprising," Reethi N. Iyengar, senior manager of health services research at Express Scripts, told TakePart. "There has been no empirical evidence on the cost impact of these medications. We hope, with this study, people will now see what has been happening over the past five years."

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The study was conducted by Express Scripts using pharmacy claims data from its nationally representative sample. The analysis focused on people ages 65 and older, both privately insured and Medicare members.

Iyengar's analysis showed diabetes medications for privately insured patients in 2011 cost, per member, an average of $81.12 per person compared to $78.38 for cholesterol medications and $73.33 for aging-related conditions. Drugs for high blood pressure and heart disease ranked fourth at $62.84.

The $73.33 spent per member, per year "might not sound like much," Iyengar notes. "But if you look at how much is spent compared to chronic conditions, it's a high amount. People are spending more on these medications for conditions that are considered to be a normal part of aging."

Other conditions considered age-related were mental alertness/memory issues, skin aging and hair loss. Among people on Medicare, medications for non-infection urinary symptoms, insomnia, and hormone replacement therapy produced the highest expenditures in the category.

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Among privately insured people, drugs for mental alertness/memory issues, non-infection urinary symptoms, and hormone replacement therapy were the top three conditions for total spending.

The rising popularity of these medications will continue to weigh heavily on the nation's overall healthcare expenditures. More than 88 million Americans will be over age 65 by 2050, Iyengar notes. The increased spending on normal aging processes could squeeze dollars available for other healthcare needs, such as immunizations and anti-obesity treatments that impact public health.

Moreover, over-spending could result in a reduction in benefits for everyone. Insurers and the federal government may need to opt for cost-containment strategies of optional, age-related medications going forward, she said.

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"Prescription benefit managers are always looking to contain cost," she says. "What this study calls for is better management of cost of utilization while insuring much-needed access to medication for patients."

The study also hints at the Baby Boomers' views of aging. Some people may feel the treatment of erectile dysfunction or skin wrinkles is important to quality of life while others say such therapies "medicalize" normal aging.

"It can definitely be argued that these medications enhance quality of life, some more than others," Iyengar says. "What we think is important is that we should be monitoring this trend, not necessarily limiting these medications or limiting access."

Question: Should insurers limit coverage for elective, age-related medications in order to hold down costs? Tell us what you think in the comments.

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