Express scripts releases first-of-its-kind study, reporting state-by-state medication usage patterns for 23 therapy classes
ST. LOUIS, -- Until now, your age and gender were among the best indicators of how you might use prescription drugs. With today’s release by Express Scripts of the first comprehensive state-by-state study of prescription drug use, where you live also can say a lot about which and how many medications you use.
According to the study, the percentage of adult beneficiaries obtaining at least one prescription in 2000 ranged from a high of 71 percent in Kansas to a low of 58 percent in California. The average number of prescriptions per member per year varied from 8.3 in New York to 12.2 in Kentucky. Generally, prescription drug use was lower in the Northeast and West, and higher in the South and Midwest.
For children, the percentage receiving at least one prescription varied from a high of 64 percent in Louisiana to a low of 48 percent in Arizona, with use higher in the Midwest and West South Central and lower in the West.
The Express Scripts research team, led by Brenda Motheral, RPh, MBA, PhD, tracked age and gender-adjusted prescription drug use for a random sample of commercially insured Express Scripts members who were continuously enrolled throughout 2000. The sample sizes for adults and children were 527,512 and 194,538, respectively, with more than 700 different client groups represented.
“Even greater variation was found when we examined prevalence of prescription drug use for 23 of the most commonly prescribed therapy categories,” said Motheral. For example, use of gastrointestinal drugs was greatest in the South, while antiasthmatic use was lower in the South. Estrogen use was lowest in the Northeast.
On a state-by-state basis, Kentucky, Louisiana, and Mississippi ranked in the top five in usage for more than ten of the 23 therapy classes. Among the lowest utilizing states, Colorado, Minnesota, Oregon and Vermont appeared in the bottom five 12 times or more and never appeared among the top five for any therapy class.
Variation in non-chronic therapy classes was greatest for cough/cold/allergy medications and in chronic classes for calcium channel blockers. Louisiana had the highest prevalence of use of cough/cold/allergy medications, with 23 percent using at least one prescription, while Vermont had the lowest prevalence of use at 7.5 percent. For calcium channel blockers, usage ranged from a high of 5.3 percent in South Carolina to a low of 1.3 percent in Oregon.
“The variation in calcium channel blocker use could reflect uncertainty regarding diagnosis and treatment,” explained Motheral, noting that the National Institutes of Health and the American Heart Association had issued statements cautioning physicians about the use of certain short-acting calcium channel blockers in specific patient groups.
“For cough/cold/allergy medications, there are a number of potential explanations for the high degree of variability", added Motheral. "Among these are climate differences and physicians' propensity to recommend non-prescription, over-the-counter cough/cold products, as well as the influence of direct-to-consumer advertising on patient preferences for non-sedating allergy and decongestant combinations available by prescription.”
Among children, the greatest variation was found for cough/cold/allergy products (26.7 percent in Louisiana vs. 3.5 percent in Maine), followed by stimulant therapy for attention deficit hyperactivity disorder (ADHD) (6.5 percent in Louisiana vs. 1.9 percent in Colorado) and antibiotic cephalosporins (19.5 percent in Louisiana vs. 7.2 percent in Washington).
“The higher variation for use of ADD stimulants likely reflects the uncertainty around the diagnosis and treatment of ADHD, while the variation in cephalosporin use may relate to differences in physicians’ propensity to reserve these medications for second-line use, although differences in bacterial resistance cannot necessarily be ruled out,” said Motheral. For cough/cold/allergy medications, the explanation for variation among children is likely to be the same for adults, according to Motheral.
“Overall, children exhibited greater variation than adults for most therapy classes. Whether greater variation is warranted for children and/or whether it reflects greater uncertainty by physicians or caregivers in the treatment of childhood ailments is an important area for further research,” said Motheral.
Express Scripts (NASDAQ:ESRX), a Fortune 500 and Forbes Platinum 400 company, is one of the largest pharmacy benefit management (PBM) companies in North America. Through facilities in seven states and Canada, the company provides pharmacy services and pharmacy benefit plan-design consultation for clients, including managed-care organizations, insurance carriers, third-party administrators, employers and union-sponsored benefit plans. Core services include pharmacy network management, mail and Internet pharmacies, formulary management, targeted clinical programs, integrated drug and medical data analysis, market research programs, medical information management, and workers' compensation programs. The company also provides non-PBM services, including distribution services for specialty pharmaceuticals through its Specialty Distribution Services subsidiary. Express Scripts is headquartered in St. Louis, Missouri. More information can be found at http://www.express-scripts.com.
Express Scripts Contacts:
Ryan Soderstrom, Corporate Communications
952-837-5160, ryan.soderstrom@express-scripts.com.
David Myers, Investor Relations
314-702-7173, david.myers@express-scripts.com