Trend shows swift rise in children taking prescription drugs

NATIONAL REPORTS-Last year, prescription drug use among children rose almost four times faster than that of the overall population The 2010 Medco Drug Trend Report shows drug spend for children increased 10.8%, along with a 5% increase in utilization in 2009.

Based on another Medco analysis, more than one in four insured children in the United States and nearly 30% of adolescents (10- to 19-year-olds) took at least one prescription medication to treat a chronic condition in 2009.

"There has been a nine-year trend in the use of medications for adult diseases in children, jumping from 23% in 2001 to 26.3% in 2009," says Amy Steinkellner, PharmD, national practice leader, Medco Women's Health Therapeutic Resource Center.

Randy Vogenberg, principal, Institute for Integrated Healthcare (IIH), sees the rise in drug utilization following on the heels of an increase in the number of births; overall rise in healthcare costs; greater availability of prescription solutions or vaccines; and faster diagnoses leading to earlier drug treatment.

WHO MODEL FORMULARY

Coincidentally, last month, the World Health Organization (WHO) released its first-ever Model Formulary for Children. As an extension of the WHO Model List of Essential Medicines, the new formulary provides standards for addressing how to use more than 240 essential medicines in the treatment of illness and disease in children 0 to 12 years of age.

It builds on the advent of medications specifically designed and tested for use in children-according to age, weight and needs of children. WHO says that 8.8 million children under age five die every year, attributable to diseases that could have been prevented by using safe and effective drugs formulated for them.

The Model Formulary for Children will provide guidance on appropriate dosing and correct formulations-and highlight potential adverse reactions and precautions. Decisions on treatment regimens are based on the best available evidence from clinical studies on children, assessed by a WHO expert committee.

For example, the guidance indicates that ibuprofen, a common pain reliever for children, can cause negative reactions with 21 other medications and should be administered with food.

DIABETES DRUG UTILIZATION RISES

The largest increases in use during the past nine years have been for diabetes, antipsychotic and asthma drugs, according to the Medco report. Medications to treat type 2 diabetes-typically not associated with children-rose by 5.3% in 2009 compared to an overall utilization growth of 2.3%. The greatest spike since 2001 was seen in girls between ages 10 and 19-a 200% increase-with a 150% jump for all children 19 and younger.

The use of atypical antipsychotics by children, used to treat schizophrenia and other psychiatric disorders, doubled over the nine-year period studied by Medco. Although the antipsychotics were more prevalent among boys, girls ages 10 to 19 represented the largest rate of growth at 130%.

Prevalence for drugs treating respiratory problems has risen 42% since 2001, but grew only 5% in 2009. This class was responsible for the highest proportion of net costs of medications for children.

On the other hand, use of antidepressants for children has declined by 3.3% during the nine-year period, which Steinkellner attributes to the 2004 Food & Drug Administration safety warnings about risk of suicide in children using the medications.

"The report is a wake-up call for the healthcare community and for parents for diligence in understanding how to manage chronic disease in children," Steinkellner says. "Appropriate use must go beyond a drug label and follow evidence-based medicine and guidelines."

She applauds the pediatric community for looking out for more diseases during regular office visits, such as high cholesterol and hypertension-once not as prevalent among children.