Almost 4 billion prescriptions for medications were written in the United States in 2010, an all-time high. Major studies that analyzed the financial impacts of increased therapeutic drug use on treatment outcomes and spending have come to different conclusions. However, it is known that many diseases can be prevented, treated effectively or cured through prescription medications.
"In some cases, the use of prescription medicines keeps people from needing other expensive health care such as being hospitalized or having surgery," notes the Kaiser Family Foundation.
Nine-out-of-10 senior citizens in the United States and more than half (58 percent) of all non-seniors regularly rely on a prescribed drug, according to the Agency for Healthcare Research and Quality.
All classes of drugs have seen an increase in prescriptions filled over the last 5 years except diuretics, penicillins, and hormonal contraceptives, according to the IMS Institute for Healthcare Informatics. IMS's analysis included all prescription medications dispensed through retail pharmacies, food store pharmacies, mail orders and long-term care facilities.
Generics Surpass Branded Drug Scripts
Generic drugs represented 75 percent of all filled prescriptions in 2010, up from 57 percent in 2004, according to IMS. While the number of generic prescriptions dispensed increased 5.9 percent; branded prescriptions declined by 7.6 percent.
The Most Prescribed Medications by Class
1. Lipid Regulators
Lipid regulators, mainly statin drugs, are used to prevent dyslipidemia (high blood cholesterol) and other cardiovascular problems and have been prescribed for the prevention and treatment of many other illnesses including osteoporosis and post-menopause complications. More than 255.4 million prescriptions for statins and other lipid lowering drugs were filled in 2010.
Pfizer's Lipitor (atorvastatin calcium) was the highest selling branded statin, followed by Crestor (rosuvastatin calcium) by AstraZeneca, Other branded statins included Mevacor (lovastatin), Pravachol (pravastatin sodium), Zocor (simvastatin), Lescol (fluvastatin sodium), Vytorin (Ezetimibe/Simvastatin), and Pitavastatin.
One of the main factors driving the increase in scripts for antidepressants is that a growing number of primary care providers and others practicing outside the field of psychiatry are writing the prescriptions for patients who have not received a clinical psychiatric diagnosis, according to a study published in Health Affairs journal in August 2011.
"Our analysis found that between 1996 and 2007, the proportion of visits at which antidepressants were prescribed but no psychiatric diagnoses were noted increased from 59.5 percent to 72.7 percent," wrote co-authors Ramin Mojtabai, Johns Hopkins Bloomberg School of Public Health, and Mark Olfson, with the College of Physicians and Surgeons of Columbia University n New York, and a research psychiatrist at New York State Psychiatric Institute.
3. Narcotic Analgesics
Narcotic analgesics are prescribed for the relief of severe pain. In 2010, more than 244,300 prescriptions were filled for these types of pain killers.
Some leading narcotic analgesics include Oxycodone (oxycodone), Vicodin (hydrocodone and acetaminophen), codeine, morphine, Percocet (acetaminophen and oxycodone), and Ultram (tramadol).
4. Beta Blockers
Beta-adrenergic blocking agents or beta blockers (plain and in combination with other drugs, are prescribed for the treatment of heart disease, particularly high blood pressure, as well as glaucoma, hyperthyroidism and migraines. More than 191.5 million prescriptions for beta blockers were filled in 2010.
Commonly prescribed beta blockers include Brevibloc (esmolol), Coreg (carvedilol), Inderal (propranolol), Lopressor, Toprol-XL (metoprolol), Normodyne, Trandate (labetalol), Sectral (acebutolol), Tenormin (atenolol) and Zebeta (bisoprolol)./
5. Ace Inhibitors
Angiotensin-converting enzyme (ACE) inhibitors are used in the treatment of high blood pressure, scleroderma, migraines and other conditions. In 2010, pharmacies dispensed more than 168.7 million prescriptions for ACE inhibitors.
ACE inhibitors include Lotensin (benazepril), Capoten (captopril), Vasotec (enalapril), Fosinopril, Prinivil, Zestril (Lisinopril), Univasc (Moexipril), Aceon (perindopril), Accupril (quinapril), Altace (ramipril) and Mavik (trandolapril).
Other top-ranking classes of drugs by millions of prescriptions filled are:
- 6. Antidiabetes; 165
- 7. Respiratory Agents; 153.3
- 8. Anti-Ulcerants; 147.1
- 9. Diuretics; 131
- 10. Anti-Epileptics; 121.7
- 11. Tranquilizers; 108.6
- 12. Thyroid Preps; 107.2
- 13. Calcium Antagonists (Plain & Combo); 97.9
- 14. Antirheumatics; 95
- 15. Hormonal Contraceptives; 92.3
- 16. Angiotensin II; 83.7
- 17. Penicillins; 76.1
- 18. Macrolides & Similar Type; 73.9
- 19. Vitamins & Minerals; 71.9
- 20. Hypnotics & Sedatives; 66
Source: IMS Health, National Prescription Audit, Dec 2010