FOCUS: PRESCRIPTION DRUGS
Majority of Americans with health insurance are on medication
Madeline Davis is like so many other Americans when it comes to her health. For years, the Williamsville resident has been taking prescription medications for myriad chronic conditions.
In her 20s, she was diagnosed with high blood pressure, a condition that runs in her family.
She also has asthma and allergies. And by 2000, she had become borderline diabetic. “[Doctors] put me on meds right away. I was a mess. When I found out I was borderline diabetic, I was scared,” said Davis, 68.
Davis is among the more than half of all insured Americans who take prescription medicines regularly for chronic health problems, according to a recent national study.
The data showed that for the first time, 51 percent of children and adults were taking one or more prescription drugs for a chronic condition in 2007, up from 50 percent the previous four years and 47 percent in 2001.
The most widely used drugs are those that lower high blood pressure and cholesterol — problems often linked to heart disease, obesity and diabetes.
“It’s a sobering statistic and one I think should make us all take account of just what we’re doing,” said Dr. Tom Rosenthal, professor and chairman of the University at Buffalo’s Department of Family Medicine.
The study, conducted by Medco Health Solutions, which manages prescription benefits for about one in five Americans, examined the prescription records of a sample of 2.5 million customers — from newborns to the elderly — from 2001 to 2007.
Local experts said the study’s results are both good and bad. The data, they said, reflects more aggressive and better treatment by doctors, better medications and better diagnoses.
The bad news, though, is that the study suggests that many Americans have unhealthy lifestyles.
“I don’t think there’s any one answer. [Americans] have huge lifestyles issues with fast food and dietary concerns and lack of physical exercise. A large part of it is that,” said Dr. Irene S. Snow, who practices internal medicine with the Buffalo Medical Group. Snow has been Davis’ doctor for more than 20 years.
Over the last two decades, prescription drugs have been developed that help people lead a better quality of life and live longer, said Dr. Alan R. Saltzman, professor and chairman of UB’s Department of Internal Medicine.
“It means we’ve got a whole armory of drugs which are useful . . . So we’re seeing a higher rate of pharmaceutical use,” he said.
More accurate diagnoses are also a factor in the increased use of medication, some health experts said.
“We are not only diagnosing better, but there is a large number of people with chronic diseases,” said Thomas Haney, wellness administrator at Independent Health.
Hand in hand with that is the fact that doctors are more aggressively treating certain conditions than they did decades ago, especially high cholesterol and blood pressure.
Doctors discovered they could prevent health complications if they could bring the numbers down to normal levels, Snow said.
And they’ve begun to better understand the long-term effects of some of these diseases.
A century ago, the medical community realized high blood pressure was bad and that people could have strokes within a month, or two, or three of getting the condition, Rosenthal explained.
Improvement in medications brought patients’ blood pressure down to moderate levels.
“And that meant maybe they wouldn’t have a heart attack for five to 10 years,” Rosenthal said.
Then once doctors realized they could control blood pressure even more, they began to use drugs to normalize levels. “So now instead of shooting for a moderate rate, we’re keeping it at an ideal rate,” he said. “If we get it down low enough, the patient may never have a heart attack.”
As a population, Americans are less physically active than in the past. Childhood obesity has become a problem, and type 2 diabetes, which was always considered an adult condition, is being increasingly diagnosed in young people.
Health professionals estimate that as much as 70 percent of chronic disease could be averted with changing behaviors related to diet, nutrition, exercise and stress management. Even if people get a chronic illness, a significant change of behavior can reduce or eliminate the need for medications.
“The caveat is that exercise is the most underwritten prescription today,” Snow said. “If you can engage in behavior modification and lifestyle modification, it may not completely eradicate [a chronic condition], but the patient may need to use less medication, and maybe a patient can get off those meds completely.”
“It’s never too late,” Haney said. “The human body is an amazingly adaptable organism. It’s outstanding in the way it can alter biochemistry.”
A lifestyle change is exactly what Davis decided to undergo.
Weighing 310 pounds, she had gastric bypass surgery in 2000 and lost 140 pounds. Then she started “living her physical life differently.”
Every day, she takes her two dogs on long walks. She takes tai chi and works out on a stationary bicycle three times a week. As a result, some of her prescriptions have been reduced, including her blood pressure medicine.
“I’ve cut back, but on some prescriptions, still maintaining some,” she said. “I feel better. I look better.”
