Pill Nation: Are Americans Over-Medicated?

Pill-Nation

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Pill Nation

American is a nation of pill poppers. Nearly 13 prescriptions were prescribed per man, woman, and child last year. We’re one of only two
countries in the world who allow direct-to-consumer Rx advertising; and Rx have slowly grown to be the third highest medical cost. Welcome
to the pill nation.

The Math
Average American= $898 in Rx spending last year. [4]
+
48.5% (1/2) of Americans on Rx last month. [6]
+
1/5 Americans on 3 or more Rx.
+
1/10 Americans on 5 or more Rx.
=
4.02 billion prescriptions filled last year. [7]

Our only larger healthcare costs = hospital care and clinical services.[5].

Rx are the fastest growing sector of US healthcare costs:
In 1980: $12 billion industry (4.9% of total healthcare spending)[12]
In 2010: $275.6 billion industry (10.6% of total healthcare spending)

Our Rx costs greatly outpace the rest of the world.
$898 per year/per American
$609 per year/per developed country citizen (and that’s by 2016!)[8]
$91 per year/per emerging country citizen (and that’s by 2016!)

Top medication types by spending:

$11 billion Antidepressants.
$7 billion on ADHD drugs.
$4.5 billion sleeping meds.

Or, $71 for every man, woman, infant and child.
Just for antidepressants, ADHD, or sleeping meds.
(And that’s with 11% of Americans not receiving Rx due to high costs.) [6]

Antidepressants: 400% rise since the 80’s[10]

ADHD Meds: [9]
(A brief timeline)

1950’s-60’s:DSM-1 (manual of psychiatric illnesses)
“Minimal Brain Dysfunction”

1960’s-70’s: DSM-II
“Hyperkinetic Reaction of Childhood”

1980’s: DSM-III
“ADD with or without hyperactivity”

1980’s-90’s: DSM-III-R
“ADHD, undifferentiated ADD”

1990’s-2000’s: DSM-IV, DSM-IV-TR
“ADHD, combined subtypes”
The arrival of:
Metadate ER, Concerta, Methylin ER, Focalin, Adderall XE, Metadate CD, Ritalin LA, Strattera, Methylin, Focalin XR, Daytrana, Vyvanse, Intuniv and Kapway.

Sleeping meds:
4% of adults take sleeping pills. Up from 0% before 1982[17]

But new drugs do cost A LOT to create

With only 1/10 medicines that are tested in human clinical trials succeeding. [13]
[pharmaceutical/number of drugs approved since 1997/total R&D Spending/ total R&D per approved Drug]
AstraZeneca/ 5/ $58.955 billion/ $11.790 billion
GlaxoSmithKline/ 10/ $81.708 billion/ $8.170 billion
Sanofi/8/ $63.274 billion/ $7.909 billion
Roche Holding AG/ 11/ $85.841 billion/ $7.803 billion
Pfizer/ 14/ $108.178 billion/ $7.727 billion
Johnson & Johnson/ 15/ $88.285 billion/ $5.885 billion
Eli Lilly & Co./ 11/ $50.347 billion/ $4.577 billion
Abbott Laboratories/ 8/ $35.970 billion/ $4.496 billion
Merck and Co Inc/16/$67.360 billion/ $4.209 billion
Bristol-Myers Squibb Co./11/$45.675 billion/ $4.152 billion
Novartis/ 21/ $83.646 billion/ $3.983 billion
Amgen/9/$33.229 billion/ $3.692

Amgen, with the lowest per drug R&D cost, could still buy:
742 Super Bowl ads
32 million official NFL footballs
4 pro football stadiums
Almost every NFL player, twice
And every seat in every NFL stadium for 12 weeks.

For the average R&D cost for one of their drugs.

The Top Twenty

Pain, Arthritis, Upper Respiratory, Diabetes Medicines dominate the list:

By Money Made:
Abilify–Anti-psychotic
Nexium–Acid-reflux
Cymbalta–Depression, anxiety, pain
Humira–Arthritis, Crohn’s disease
Crestor–Cholestoral
Advair Diskus–COPD, Asthma,
Enbrel–Arthritis
Remicade–Arthritis, Crohn’s disease
Copaxone–Multiple sclerosis
Neulasta–White blood cell shortage
Rituxan–Arthritis, lymphoma
Spiriva–COPD, asthma
Atripla–HIV
Lantus Solostar–Diabetes
Januvia–Diabetes
Avastin–Cancer
OxyContin–Pain
Lantus–Diabetes
Lyrica–Neuropathic pain
Truvada–HIV

By Packages Sold:
Budesonide–Asthma
Acetaminophen/hydrocodone–pain, inflamation
ProAir HFA–Bronchitis, COPD, Asthma
Cymbalta–depression, pain
One Touch–Diabetes
Nexium–Acid Reflux
Advair Diskus–Asthma, chronic bronchitis
Lantus–Diabetes
Omeprazole–Acid reflux
Lantus Solostar–diabetes
Atorvastatin–cholestoral
Enoxaparin–blood thinner
Fentanyl–pain
Crestor–cholestoral
Ventolin HFA–Asthma, bronchitis
Spiriva–COPD
Levemir–Diabetes
NovoLog FlexPen–Diabetes
metoprolol–blood pressure, angina
Novolog–Diabetes

Why?

The U.S. is one of only two countries in the world allowing pharmaceuticals to advertise directly to everyday people.
New Zealand
And
The US

2011 spending on ads by pharmaceuticals: $2.4 billion
Where every $1 spent on advertising increases retail sales by $4.20.[14]

The Jury’s Out:

[15]
With 1/2 of doctors thinking patients who see direct-to-consumer advertising ask more informed questions.
And the other 1/2 disagreeing.
And 8% of Doctor’s feeling strongly pressured to prescribe the advertised drug.

And it’s likely to stay that way, with the pharmaceutical lobby being one of the strongest in the U.S.
With over 1,300 lobbyists spending $171 million last year.
Including many of our big researchers above:
[client/spending on lobbying][16]
Pharmaceutical Rsrch & Mfrs of America $13,802,500
Eli Lilly & Co $7,400,000
Pfizer Inc $6,800,000
Amgen Inc $6,790,000
Novartis AG $6,135,000
Biotechnology Industry Organization $5,960,000
Sanofi $5,528,000
Merck & Co $5,210,000
Johnson & Johnson $4,755,000
Bayer AG $4,090,000

Hey, it’s big business. Welcome to the Rx Nation

Pill-Nation

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