Point for Discussion
Why are people, especially older people, taking so many prescriptions? Is it because they really need them, in the quantity, dose and price they pay, or is it because drug manufacturers have found a robust market among prescribing doctors and under-informed consumers?
Points of View
With every prescription comes a myriad of side effects, some of which sound worse than the condition being managed. Some side effects are due to the drug itself, and others can happen due to interactions between drugs. Still other side effects are not visible (e.g., blood thinners that can cause massive internal bleeding) that can actually accelerate death (like it did for our mom). Some drugs over-treat a condition. It may work, but at what risk, and is it really necessary?
People just want to BE better, FEEL better, and better MANAGE their lives. They don’t expect perfection, but are not always fully aware of the implications, despite their efforts to be informed.
Think about it:
- According to AARP, between 1986 and 2002, the average person aged 45+ years, took an average of 4 medications DAILY. I imagine this is much higher for people 65+, and has at least doubled through 2017. (I’m making this last part up, but I bet I’m close). And how many “non-daily” medications are they taking? Then add in the supplements…..
- Those daily pill organizers now have an “AM” and “PM” row (and for some, “Noon” and “Midnight”!) to help know when and what to take (it’s almost a day job just organizing pills).
- Pharmaceuticals are so expansive that manufacturers are using advertising to ask patients to ask their doctors about their drugs so they don’t have to rely only on the doctors to prescribe them.
- And related, manufacturers now show the phonetic pronunciation of the drugs in order to even ask for them (e.g., farxiga, the “f” drug). And do we, as consumers, really care about the scientific name for the drug? Who gives a hoot?
- Lastly, to what extent are prescriptions artificially prolonging life? Do we really need to live to be 100 years old?
There are many things that could be done to help people better limit and manage the prescriptions they take (beyond our own responsibility to ask a lot of questions before deciding to take them):
- Doctors could help to better manage the number of prescriptions by only prescribing the minimum # and type required.
- Where multiple prescriptions are required, can’t there be a pharmaceutical that addresses more than one condition at the same time, and at a lower dose (and less risk): This could be similar to what a multi-vitamin can do, but for prescriptions, for most common conditions (e.g., diabetes, heart disease, high blood pressure) that are often occurring at the same time for some patients.
- Couldn’t prescribing be regulated, at a minimum, to help protect people from the portion of doctors who don’t do their diligence and over-prescribe (think blood thinners, think opioids, think unintended overdoses, etc.)?
- And couldn’t there be better pricing? If drug manufacturers can offer “assistance” to those who can’t afford it (as they say in their ads), there should be a more balanced price to consumers. Is it that regulations and the intense level of clinical trials are too much of a cost burden that is then passed on to consumers? Isn’t there a happy medium that balances investment required by manufacturers and the price to consumers? They have patent protection for the market, so it’s time to think differently, and to put people first.
Health care is certainly challenging these days. We are bombarded with advertising for all of the latest drugs out there. Everything from anti-depressants to arthritis meds. If we were all doctors this would be great. I don’t know about you, but I am not a doctor, and have no desire to be one. I rely on my health care providers to guide me.
Our healthcare providers prescribe medications that they believe are in our best interests to take. These meds can manage chronic conditions like high blood pressure, high cholesterol or diabetes. For many, they are a life saver. Medications make these conditions almost effortless to deal with-we need to understand the conditions, but the meds keep them under control. Our lives are improved and extended for years. And several medications to manage these conditions are free or available inexpensively through certain pharmacies. For me, my thyroid meds are actually cheaper without running it through my insurance.
As researchers continue to work on treatments to cure many other life impacting conditions, they have taken to advertising on TV and in magazines to make sure we are aware they exist. During the initial patent period, when no generics are available, the pharmaceutical companies can charge what they want in order to recoup costs of development and testing. It is in their best interests to sell as much as possible to accomplish this. So they advertise. We go to our doctors and ask about these new meds, something we wouldn’t have done 30 years ago because we would not have been aware of them. We still need to rely on our doctors to know if they will work for us, advise us of all of the potential risks and side effects, and ultimately help us decide if we want to try them.
Are the prices for new medications high? Yep. If we want to live longer, improve our quality of life, or manage a chronic condition, we will consider using them. For those of us with insurance, the cost has remained manageable (if we are lucky enough to have the insurance company approve the prescription) but for many, the prices have risen to a point where people have to choose between eating and taking their meds. While many pharmaceutical companies offer financial assistance, it isn’t available for everyone.
Then there are the drug interactions. Many medications interact badly. If we have several doctors that are not aware of what has been prescribed by other physicians, we run the risk of a bad reaction. The Pharmacist at our local drugstore was invaluable in making sure we were aware of the potential risks so that we could contact our doctor and make sure we didn’t do anything dangerous. We are grateful for the current sharing of information between healthcare providers so that our risk is minimized. Absent that, the internet can provide the same information and has become a resource I use regularly to verify what I’ve been told or answer questions I may have.
As we live longer, we will likely be prescribed all sorts of medications to extend our lives. It is up to us to make sure that we are not taking more than we need and to ensure that the side effects are worth the benefits we get.
Americans take a lot of medications when compared to the rest of the world. While we are living longer, is it truly better living through chemistry?
Our Question for you
If you or someone you know is taking multiple prescriptions, what would you like to see done to address the challenges you or they are experiencing? Or if you’ve found a great way to manage prescriptions, let us know that, too!