How to save $213 billion — and your own life

by Grace-Marie Turner

Are we taking too many drugs?

The Twitter-verse is abuzz over a new study released by the Mayo Clinic which found that 70% of Americans are taking at least one prescription drug.

A second independent study, conducted by the IMS Institute for Healthcare Informatics, provides relevant insights.  IMS found that if we used prescription drugs more wisely, the U.S. could save at least $213 billion a year in health care expenses. The key is reducing medication overuse, underuse, and improper use.

So it’s good we are taking drugs.  We just need to make sure we are taking them the right way.

Dozens of earlier studies have shown that taking and properly taking prescribed drugs ultimately reduces overall health care costs, and the newer the drug, the greater the reduction in other health expenses.  The two new studies provide more detailed information to quantify where money is being spent and mis-spent on health care.

IMS, part of data analysis and consulting firm IMS Health, said $213 billion could be saved if doctors and patients would make better use of medication, including timely diagnoses so patients get treatment earlier in the course of an illness and take medicines as directed by the doctor.

The savings represent nearly 8% of the $2.8 trillion the U.S. will spend on health care this year – which could pay several times over for everyone in the country to have health coverage without the massive taxes and Medicare cuts in the Affordable Care Act.

IMS researchers generally focused on spending on a handful of very common or very expensive diseases — from high cholesterol and blood pressure to HIV and diabetes — for which costs of care and complications are well documented.

Murray Aitken, IMS executive director, told The Associated Press that more-appropriate use of medications — taking them exactly as prescribed, not taking antibiotics for viral illnesses, preventing medication errors, and the like — could prevent 6 million hospitalizations, 4 million trips to the emergency room and 78 million visits to doctors and other outpatient care providers each year.

“Those are staggering numbers,” Aitken said.

The IMS report, titled “Avoidable Costs in Healthcare,” found the biggest area of waste is patients not taking medicines prescribed by their doctor, either at all or as directed. IMS estimates the cost of such “non-adherence” at about $105 billion a year.

The IMS study shows that misuse of antibiotics for viral illnesses is one of the most common mis-uses of prescription drugs. And the Mayo Clinic study shows that the most common drug Americans take is antibiotics – 17% among those studied.  Clearly, these two studies reinforce concerns about a public health issue that needs even greater attention.

IMS found the misuse of antibiotics contributes to an estimated $34 billion each year in avoidable inpatient care costs. An additional $1 billion is spent on about 31 million inappropriate antibiotic prescriptions that are dispensed each year, typically for viral infections.

The next most common prescription is for antidepressants (13%), and an equal percentage were taking opioids. Drugs to control high blood pressure came in fourth (11%) and vaccines were fifth (11%).

The prevalence of antidepressant and opioid use shows that the medical community needs to be vigilant in making sure that people are using drugs to treat illnesses, not mask symptoms.

Mayo also showed that 20% of U.S. patients were also taking five or more prescription medications.  These are often patients with chronic illnesses, likely multiple chronic illnesses, for whom the drugs are vital to keeping them out of the hospital and possibly even to keeping them alive.

These two new independent studies provide a keen insight into important information about changes needed to advance public health and which suggest the importance of physician and public education: Take your medicines, but listen to your doctor and take them properly.