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Pediatric spending spike on drugs to treat behavioral problems. - Mental Health Weekly Digest

2004 JUN 14 - (NewsRx.com & NewsRx.net) -- Spending on drugs primarily used to treat attention deficit hyperactivity disorder (ADHD) surged 369% for children under age 5 as the number of kids taking one or more prescription medicines to treat behavior-related conditions hit nearly 9% for those children taking as least one medication overall, according to new data released at the Medco Health Solutions 2004 Drug Trend Symposium.

'This analysis provides a striking commentary on the state of pediatric treatment in this country, as well as the costs shouldered by parents whose children live with these conditions,' said Dr. Robert Epstein, chief medical officer, Medco (MHS). 'It goes without saying that early detection and appropriate treatment of these conditions is extremely important, but the emphasis is on 'appropriate' with an eye on cost-effective therapy, as well.'

The research reviewed the prescription data of 300,000 children ages 19 and younger in four major categories of behavioral medications used to treat a variety of conditions including ADHD, depression, autism, and conduct disorders. Although recent studies have found an increase in the use of antidepressants, the Medco research found an even greater growth in the utilization of medications used to treat other behavioral conditions.

Among the major findings of the analysis:

1) Prescription drug spending for behavioral conditions rose 77% between 2000-2003 due to both increased costs and increased use of these medications.

2) In 2003, spending on behavioral medications to treat children overtook both the antibiotic and asthma categories, which are traditionally high-use categories in pediatric medicine.

3) The number of children on behavioral medications has jumped more than 20% between 2000-2003, outpaced only by the increase of children on drugs to treat gastrointestinal conditions, which increased by nearly 28%.

4) Among the largest increases were medications primarily used to treat attention deficit hyperactivity disorder - where spending increased by 183% for children overall, and by 369% increase for children under age 5. Utilization in preschoolers was up 49% from 2000-2003.

5) Spending on antidepressants for children grew 25%, while use of these drugs rose 27% between 2000-2003. A review of 2004 data shows that of the children on at least one prescription medication in the first quarter of this year, the number of children using antidepressants increased by 15% over the first 3 months of 2003.

6) The number of children on medications to treat severe behavioral conditions related to autism and conduct disorders increased by more than 60% from 2000-2003, while spending on these drugs rose 142% in the pediatric group. Among children ages 5-9, utilization was up 85%, while spending in this category grew 174%.

7) Although children continue to predominantly use antibiotics, allergy, and asthma drugs, the rate of increase in utilization and cost for these categories has been more moderate over the past 4 years than for behavioral medications; antibiotics showed no change in utilization and a 24% increase in spending; the use of allergy treatments increased 3%, while spending decreased by 7%; and asthma medications showed a 12% increase in utilization and a 24% rise in costs.

Medco's annual Drug Trend Report examines the drug spending experience representative of its more than 60 million members to help identify factors that contribute to the rising costs of prescription drug care. The total number of dollars vested in prescription medications for patients under age 19 remains a relatively modest percentage compared to other age groups, however the rate of increase in spending was significant - an indicator of future trends.

Surprisingly, the average unit cost per child per day is more than 60% higher than that of seniors. Although children take fewer medications than seniors, medications used by children have the highest average cost - $2.12 per day for children versus $1.29 per day for seniors.

'The unit costs of medications for children outweigh that of all other age groups, so we have made it a priority to help our clients understand the factors that drive pediatric drug trend, and offer solutions to those challenges,' said Epstein. 'Through education and encouraging appropriate medication use, plans can help curb the explosive trend in the pediatric population.'

Medco Health Solutions, Inc., a pharmacy benefit manager with mail order pharmacy operations, assists its customers to moderate the cost and enhance the quality of prescription drug benefits provided to members nationwide.

This article was prepared by Mental Health Weekly Digest editors from staff and other reports. Copyright 2004, Mental Health Weekly Digest via NewsRx.com & NewsRx.net.