UPDATE 1-Prescription drug use by US children on the rise

* 1-in-4 children took drugs for chronic conditions in '09

* Juvenile use of diabetes drugs, antipsychotics on rise

* Medco medical director calls child data a "shocker"

* Medco sees overall pharma spend up 18 pct through 2012 (Adds comment from Medco medical director, disease category details, byline)

By Bill Berkrot

NEW YORK, May 19 (Reuters) - Children were the leading growth demographic for the pharmaceutical industry in 2009, with the increase of prescription drug use among youngsters nearly four times higher than in the overall population, according to a report by Medco Health Solutions Inc MHS.N.

More than one in four insured children in the United States and nearly 30 percent of adolescents aged 10 to 19 took at least one prescription medicine to treat a chronic condition in 2009, according to an analysis of pediatric medication use conducted as part of Medco's drug trend study issued on Wednesday.

Medco is forecasting overall pharmaceutical spending to rise up to 18 percent through 2012, driven by diabetes, cancer and rheumatology treatments. Spending is expected to rise 3 percent to 5 percent this year, and 4 percent to 6 percent the next two years.

Overall increases will be somewhat held down by some $46 billion in branded drug sales that will succumb to competition from cheap generic versions by the end of 2012.

But the increases in prescription drug use by children for chronic conditions could fuel significantly higher health care costs as those young patients enter adulthood, Medco said.

"Looking at children was the real shocker for us," Dr Robert Epstein, Medco's chief medical officer, said on a conference call from Medco's drug trend symposium in Orlando, Florida.

Over the past nine years, the most substantial increases in the medicating of children were seen in drugs for conditions not typically associated with them, such as for type 2 diabetes and antipsychotics, Medco said.

Some long-standing childhood maladies also saw large increases, such as asthma.

OBESITY LINK

"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.

"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.

Medco and other pharmacy benefit managers, or PBMs, administer prescription drug benefits for employers and health plans and also run large mail-order pharmacies. Data for the study was collected from Medco's top 200 clients, representing more than 40 million people.

Childhood use of medications for type 2 diabetes, a disease once referred to as adult onset diabetes, rose 5.3 percent in 2009 and is up more than 150 percent since 2001, the study found. Girls between the ages of 10 and 19 showed the greatest jump at nearly 200 percent over nine years.

"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.

ANTIPSYCHOTICS

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

Use of such drugs has doubled since 2001 and more than doubled for girls, according to Medco's nine-year analysis.

Use of some antipsychotics has also been associated with significant weight gain and increased risk of developing type 2 diabetes, potentially compounding health problems.

There was a 23 percent drop since 2004 in use of antidepressants by youngsters. That decline followed U.S. Food and Drug Administration warnings of the increased risk of suicidal thoughts by children using those drugs.

Rates of childhood asthma are also on the rise, Medco found. Respiratory drug use grew 5 percent among children in 2009 and is up 42 percent since 2001.

Use of drugs for attention deficit hyperactivity disorder (ADHD), often cited in reports on the over-medication of children, is also on the rise. But surprisingly, the increase was more pronounced among young adults.

Overall ADHD drug use was up 9.1 percent last year, leading to a 23.8 percent rise in spending growth. But the utilization increase was 21.2 percent among those aged 20 to 34. (Reporting by Bill Berkrot; Editing by Tim Dobbyn)