Children's consumption of chronic medications on the rise, new research shows

In growing numbers, children across the United States are adding a dose of medicine to their daily routine. In 2009, the drug trend for children, a measure of prescription spending growth, increased 10.8%, driven by a 5% increase in drug utilization and higher medication costs, according to the Medco 2010 Drug Trend Report. The growth in prescription drug use among children was nearly four times higher than the rise seen in the overall population.

A corresponding analysis of pediatric medication use found that in 2009, more than 25% of insured children in the United States and nearly 30% of adolescents (aged 10–19) took at least one prescription medication to treat a chronic condition.

Type 2 diabetes medication use by juveniles increased 5.3% in 2009, the largest increase across all age groups, and higher than overall utilization growth of 2.3%. Since 2001, the number of children aged 19 and younger using these medications has risen more than 150%, with girls between ages 10 and 19 showing the greatest jump at nearly 200%. While growth in use of these treatments is substantial, the actual number of children using these drugs is still far less than is seen in adults.

The obesity epidemic may also be responsible for a higher prevalence of hypertension and gastroesophageal reflux disease (GERD) in youngsters. From 2001 to 2009, there was a 17% increase in the use of antihypertensive drugs in children, with the greatest growth (29%) seen in boys aged 10 to 19. The number of children on proton pump inhibitors, used to treat heartburn and GERD, and in some cases prescribed for colic in infants, increased by 147% from 2001 to 2009.

“What is most important, and frankly most startling, [about the study results] is that we are seeing adult-like diseases such as type 2 diabetes and hypertension in children, which years ago we never saw,” Robert S. Epstein, MD, chief medical officer for Orlando, Fla.–based Medco and president of the Medco Research Institute, tells Formulary journal. “And the scary thing is that the numbers are growing.

“The fact that one-in-three adolescents are being treated for a chronic condition points to the need for additional health education and lifestyle changes that can address the obesity issue that is likely a driving force behind such conditions as type 2 diabetes and even asthma,” he added.

He tells Formulary journal that the medical and pharmaceutical industries must do more to support programs to fight obesity, such as First Lady Michelle Obama’s “The Fight Against Childhood Obesity” initiative. “Obesity is a contributing factor to many of the chronic conditions we’re seeing in kids,” he said. “Programs that educate about nutrition and making healthier choices, along with providing physical fitness opportunities, would help to prevent the child from needing medication in the first place.”

Utilization and costs of behavioral drug treatments continue to rise in children. In 2009, 13.2% of the prescription drug benefit dollars spent on children went to ADHD treatments. However, the greatest spike in utilization growth last year was not seen in the youngest demographic but rather in adults aged 20 to 34, where use of these drugs rose 21.2%.

During the past 9 years, there were substantial increases in the use of antipsychotic, diabetes, and asthma drugs, according to the report. Among the drugs that have experienced substantial gains in the pediatric population are atypical antipsychotics. Traditionally used to treat schizophrenia, these drugs have more recently been prescribed for a variety of psychiatric disorders. The 9-year analysis revealed that the use of these treatments in children has doubled over that time period. While use of atypical antipsychotics are still more prevalent among boys, the rate of growth (130%) was greatest in girls aged 10 to 19.