Medicine use continues to rise

Medicine use continues to rise

New Zealanders are taking more medicine than ever before, according to figures just released by drug funding agency PHARMAC.

In the year to June 2003, New Zealand patients were written some 22.4 million prescriptions for subsidised medicine (accounting for about two-thirds of all prescribed medicines by value).

That’s a 5.3 percent increase from the previous year, and averages out at more than five prescriptions per year for every man, woman and child in New Zealand.

Figures published today in PHARMAC’s 2003 Annual Review show the overall rise in prescriptions has come while some medicines have seen a fall in use. These include hormone replacement therapy (down 38 percent) and some of the more commonly-prescribed antibiotics.

So are we a nation of pill-poppers? PHARMAC Chief Executive Wayne McNee says there may be overuse in some instances, but there are examples in the past year of large increases in some medicines where there has been under-use in the past, including for cholesterol-lowering statins.

“Growth in prescription volumes is one of the continuing issues PHARMAC faces,” Wayne McNee says. “It puts continuing pressure on the medicines bill and is one of the reasons why PHARMAC has to devote so much energy to reducing medicine cost.

“Volume growth is one of the major factors impacting on New Zealanders’ ability to access new subsidised medicines. If medicine volumes stayed as they are, the savings that are currently achieved could all be used to fund new medicines.”

Medicines to show significant rises included antidepressants, new generation antipsychotic medicines, and the stomach ulcer drugs known as proton pump inhibitors.

So what causes the ongoing increase in prescribing? Some causes include changes in population size and mix factors, such as ageing, and increases in prescribing as a result of decisions by PHARMAC. However, medicalisation and medicine advertising can also be drivers of prescribing patterns. [more]

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“It’s obvious from looking at the data that those medicines marketed and promoted most heavily are those more commonly prescribed, so there is clearly a correlation between medicine promotion and prescribing,” Wayne McNee says.

A related issue is inappropriately high doses of some medicines, including inhaled corticosteroids for asthma relief. PHARMAC launched a campaign in 2003 to address what clinicians agree are inappropriately high doses. Where PHARMAC decisions have led to an increase in usage, these have been accompanied by a careful analysis to show a positive impact on people’s health.

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