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Americans relying more on prescription drugs { December 3 2004 }

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December 3, 2004
Americans Relying More on Prescription Drugs, Report Says

WASHINGTON, Dec. 2 - More than 40 percent of Americans take at least one prescription drug, and 17 percent take three or more, the government said Thursday in a comprehensive report on the nation's health.

The report documented the growing use of medications in the last decade, a trend that it attributed to the growth of insurance coverage for drugs, the discovery and marketing of new products, and clinical guidelines that recommend greater use of drugs to treat high cholesterol, high blood pressure, diabetes and other conditions.

Health spending shot up 9.3 percent in 2002, to $1.6 trillion, but Americans seem to be getting some benefits from it, the report said. Life expectancy at birth increased to 77.3 years in 2002, a record, and deaths from heart disease, cancer and stroke - the nation's leading killers - declined.

But, the government noted, "men and women have longer life expectancies in many other countries," including Japan, Italy and Canada.

Use of prescription drugs in the United States is rising among people of all ages, and the nation's medicine chests are more crowded than ever.

Prescription drugs account for about 10 percent of the nation's total medical bill, but since 1995 drug spending has grown faster than spending for any other category of medical goods and services, the government said.

Nearly half of all women - 49 percent - were taking prescription drugs in 1999-2000, compared with 39 percent of men.

Adults' use of antidepressants almost tripled from 1988 to 2000. Use was higher among women than among men. In 1999-2000, 10 percent of women 18 and older reported taking antidepressants in the previous month, compared with 4 percent of men.

Use of cholesterol-lowering statin drugs among people 45 and older more than tripled from 1995 to 2002, the report said.

Amy B. Bernstein, chief of analytic studies at the National Center for Health Statistics, which issued the report, said, "Women 65 and older are no less likely than men of the same age to have high cholesterol, but doctors are less likely to report prescribing statins for their female patients."

Medical records from doctors' offices and outpatient hospital clinics indicated that men 65 and older were about 25 percent more likely than women to receive or be taking statin drugs, which include Lipitor, Pravachol and Zocor.

The report also confirms a sharp increase in the use of stimulants by children ages 5 to 17. Such drugs, like Ritalin, are often used to treat the impulsive, aggressive traits known as attention deficit hyperactivity disorder, the most commonly diagnosed psychiatric disorder in children.

Boys are much more likely than girls to receive such drugs when they visit doctors' offices and clinics. In 2000-2002, the government counted an average of 13.5 such visits for every 100 boys ages 5 to 17, up from an average of 8.5 visits in 1997-1999. The comparable figures for girls were 5.3 and 3.3.

By contrast, antidepressants were prescribed at similar rates for boys and girls, and in both cases the rates increased sharply from 1994 to 2002.

The report also shows a sharp increase in heart surgery among elderly patients in the last decade. Ms. Bernstein said this reflected an increase in procedures to clear clogged arteries and to insert the wire mesh tubes known as stents, which prop open the arteries.

In 1991-92, the government said, hospitals reported 73 operations on heart vessels for every 10,000 people age 75 and over. The rate rose 70 percent in the following decade, reaching 124 procedures for every 10,000 people of that age in 2001-2. The procedures are performed more than twice as often among men as among women, the government said.

In 2002, the infant mortality rate was 7 deaths for every 1,000 live births, up from 6.8 in 2001. Much of the increase was attributed to deaths in the first month of life, especially the first week.

Large racial and ethnic disparities persist. The infant mortality rate for 2002 was 5.8 deaths for every 1,000 births among whites, compared with 13.8 for blacks, 5.6 for Hispanics and 4.8 for Asian Americans.

Mortality from heart disease, the leading cause of death, declined almost 3 percent in 2002, continuing a long-term trend.

Mortality from cancer, the second leading cause of death, decreased more than 1 percent in 2002, continuing a decline that began in 1990.

Copyright 2004 The New York Times Company

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