Medco Medical Director Calls Child Prescriptions Use A "Shocker"

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Children are the leading growth spurt for the pharmaceutical industry and in 2009 prescription drug use among youngsters increased to nearly four times higher than in the overall population, according to a report by Medco Health Solutions Inc."Looking at children was the real shocker for us," Dr Robert Epstein, Medco's chief medical officer.

The big pharmacy benefit manager says in its annual drug trend report that the boost in spending for the under-19 crowd represented a combination of higher prices and a 5% uptick in drug use also the biggest increase for any age group. Medco’s report is the latest to point out sharp increases last year in the prices of brand-name drugs. The PBM says those prices rose 9.2%, which company officials said was the most they’ve seen this decade.

David Snow, Medco's CEO, said the big price jump has a lot to do with the looming tax on pharmaceutical companies to help pay for health overhaul. "No one is going to absorb this kind of cost without passing it on to the ultimate" customer, he said of the drugmakers' price increases.

Among the trends was the rise in children taking antipsychotics which is a very powerful drugs traditionally used to treat schizophrenia, but increasingly prescribed for other conditions, such as depression and anxiety.

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"Atypical antipsychotics are extremely powerful drugs that are being used far too commonly especially in children given their safety issues and side effects," said Dr. David Muzina, a specialist in mood disorders and national practice leader of the Medco Therapeutic Resource Center for Neuroscience. "We're seeing them prescribed for a number of different conditions including depression and anxiety for which there is not good evidence that they are an effective treatment and yet we're exposing children to the possibility of extreme weight gain that could lead to a host of health problems including diabetes."

Use of such drugs has doubled since 2001 and more than doubled for girls, according to Medco's nine-year analysis. ADHD drugs use was up 9.1 percent last year, leading to a 23.8 percent rise in spending growth.

"What's surprising is the type of drugs these kids are taking. All these adult drugs are popping up in children, which is really disturbing," Epstein said. "Children are looking like little versions of adults when it comes to chronic illness."

"The obesity problem is contributing not just to diabetes but to a lot of other problems," he said, noting a 50 percent increase since 2001 in use of cholesterol lowering drugs among those aged 10 to 19, a 24 percent increase in use of blood pressure medicines, and a whopping 147 percent jump in adolescents taking heart burn and acid reflux drugs. In addition, childhood use of medications for type 2 diabetes which was once referred to as adult onset diabetes rose 5.3 percent in 2009.

"We've got to get our arms around some very fast lifestyle modification or we're going to have a real problem, having these adult illnesses show up in children who will have a changing life expectancy if they're going to be sick from a very young age," Epstein cautioned.

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