In a recent post, we commented on IMS data showing a decline in U.S. drug sales in 2008. Now Medco, a pharmacy benefits manager, expanded on this information. According to the new data, there was an overall decline in the number of prescriptions written by physicians, the first time in a decade. While one would assume that the economic crisis contributed to this decline, Medco attributes the results to declines in specific drugs, such as Zyrtec (allergy) going off-patent and Avandia (diabetes) and Vytorin (cholesterol) facing safety issues. Medco also points out that the FDA approved fewer drugs last year.
Is this a one-year anomaly or the beginning of a trend? Obviously, it is hard to tell, especially this year, the year of the great healthcare reform. If more people suddenly become insured, it is a safe bet that the total number of prescriptions written will rise, despite the likelihood for longer waits for patients to see their doctors. On the other hand, over time, better implementation of various prevention policies could enhance overall health and reduce the need for prescriptions.
Whenever I look at data like these, I’m reminded that as a society we tend to rely too much on prescriptions. The pharmaceutical companies have a lot to do with this–by “inventing” or exaggerating the importance of new diseases, by extending patent lives of drugs by questionable improvements, by marketing directly to consumers, etc. But it’s also true that many drugs are essential for preserving health. What is missing from our healthcare culture is the correct balance between the two. It doesn’t appear that, so far, market forces did a good job in this respect.
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