* 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
By Bill Berkrot
NEW YORK, May 19 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
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,
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.
"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.
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)