Prescription Drug Use in America

The Startling Numbers And Their Implications

In 2002, Americans filled 3,340,000,000 outpatient prescriptions.1 That's 12 prescriptions for every man, women, and child in America. Has the American dream become 2 kids, 2 cars, and a dozen drugs in each person's medicine chest?
Despite a cold economy in which most industries have seen sales drop, U.S. drug sales increased substantially in 2002, reaching $219 billion. According to NDCHealth, overall drug sales (all sources) grew 12% 2002, 18% in 2001, and 15% in 2000 (based on wholesale acquisition costs). 1
The trend of doctors writing more and more outpatient prescriptions each year continues without pause: 1,2

2002: 3,340,000,000 Rx
2001: 3,200,000,000 Rx
2000: 2,979,000,000 Rx
1999: 2,821,000,000 Rx
1998: 2,523,000,000 Rx

The cost of these drugs has more than doubled in five years.
The outlook for the future? According to Pharmacy Times last year: "For the past 3 years, prescription volume has grown by 25% in the United States, and there doesn't appear to be a slowdown in sight."2
I'm not anti-medication. Medications do a great deal of good, but we must ask, what is the goal of the drug industry? To simply sell as many drugs as possible? Yet, medications aren't like other commodities. Prescription drugs aren't the same as cars, cosmetics, or CD players. Drugs have direct, powerful effects on human systems. Some of these effects are negative, and taking multiple drugs -- as 25% of Americans do -- increases the risks exponentially. Psychologically, the growing attitude that drugs are the answer for every ache and angst is destructive for individuals and societies.
Prescription medications are vitally important for treating medical conditions, but they are also the #4 leading cause of death, cause more than 1 million hospitalizations annually, and are a major cause of disability and drug dependency.3 Over-use of medications is rampant.
Many doctors treating high cholesterol and high blood pressure turn to drugs without ever discussing diet and exercise, although many of these disorders are nutritional, not medical. Many patients prefer a pill to changing harmful habits. With drug advertising everywhere, what is the message being drummed into us and our children: that for every symptom and sensation the solution is a pill?


"The drug industry has been the most profitable industry by far year after year. Drug companies need profits to conduct research, but how much is enough, when most profits go to marketing, promotions, and the development of unneeded me-too drugs?"



The drug industry has been the most profitable industry by far year after year. Last year, Public Citizen stated: "While the overall profits of Fortune 500 companies declined by 53% [in 2001], the top 10 U.S. drug makers increased profits by 33%. These companies had the greatest return on receipts, reporting a profit of 18.5 cents for every $1 of sales, which was eight times higher than the median for all Fortune 500 industries."4
Meanwhile, drug costs are driving health insurance expenditures and your premiums through the roof. They are driving thousands of people to Canada and Mexico for drug prices they can afford. For many people, it comes down to medications or food. For many healthcare systems, Rx drugs cost more than all of their doctor visits or hospitalizations combined. Drug companies need profits to conduct research, but how much is reasonable, especially when the greatest proportion of these profits go to marketing, promotions, and the development of unneeded me-too drugs?
Here are the big $ales winners in 2002:

1. Lipitor (cholesterol-lowering): $5.58 billion (up 18%)
2. Zocor (cholesterol-lowering): $4.069 billion (up 18%)
3. Prevacid (ulcers, reflux): $3.894 billion (up 4%)
4. Prilosec (ulcers, reflux): $3.341 billion (down 22% after going generic in 2002)
5. Procrit: >$2 billion, exact numbers N/A
6. Zyprexa (neuroleptic): $2.716 billion (up 15%)
7. Paxil (SSRI antidepressant): $2.509 billion (up 13%)
8. Zoloft (SSRI antidepressant): $2.445 billion (up 13%)
9. Epogen: >$2 billion, exact numbers N/A
10. Celebrex (anti-inflammatory): $2.380 billion (up 5.3%)
11. Nexium (ulcers, reflux): $2.000 billion (new drug)
12. Neurontin (seizures, pain): $2.000 billion
13. Norvasc (antihypertensive): $1.814 billion (up 5%)

Prescription drug use and costs are like a runaway train. Where is it heading? Can we, should we, try to slow it? Is there an optimal balance between effective medication use and overmedication? Can we find it?
The mission of this newsletter and website is to discuss issues about drug use, drug safety, and proven-effective alternative methods that mainstream medicine and the media ignore. These issues affect every family in America and the developed world. I'll have a lot more to say on these issues in subsequent newsletters.


References:
1. NDCHealth, a healthcare information services company. Atlanta, GA, Apr. 1, 2003:www.ndchealth.com.
2. Top 10 Drugs of 1997-2001. Pharmacy Times, April editions in respective years.
3. Lazarou, J, Pomeranz, BH, Corey, PN. Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies. JAMA, 1998 Apr 15, 279(15):1200-5.
4. Public Citizen. Pharmaceuticals Rank As Most Profitable Industry, Again. Public Citizen, 4/18/02:citizen.org.

Machiavelli Was Right

by Charley Reese

Niccolò Machiavelli, who was a sort of Karl Rove of his day, though with more integrity, said of the Swiss that they were "the most free and most armed people" of Europe. Get it? The connection between arms and freedom?

That statement is still true of the Swiss. Many people know that they practice neutrality, but not many know that they practice armed neutrality. If the gun controllers' claim that the mere presence of arms leads to mayhem were true, the Swiss would have wiped themselves out years ago. There are guns and gun ranges all over the place. You would be hard-pressed to find a Swiss home without a firearm and ammunition. Yet, the Swiss have a very low crime rate.

If you were a robber or a rapist, who would you rather have as a victim? Someone who is armed, or someone who is defenseless? Even a stupid criminal knows the answer to that question.

If the police can protect us – which is another claim the gun-control people make – then why are so many people murdered, raped and robbed? Even the television fictional stories tell you the answer to that. The cops get there after the crime has been committed. Otherwise, there wouldn't be a crime scene. Nearly all the cop shows open with the police looking at a dead, unarmed body.

Do you really believe that the men who had just fought a long and bloody war against the British and were writing what we call the Bill of Rights had this conversation:

"Well, let's see. We've guaranteed freedom of assembly, of religion, of speech and of the press. Oh, my gosh, we've forgotten the duck hunters. They'll raise heck if we leave them out, so we'd better write an amendment for them."

The Second Amendment has nothing whatsoever to do with hunting. It states: "A well-regulated militia being necessary to the security of a free state, the right of the people to keep and bear arms shall not be infringed."

The men who wrote these amendments were pretty darn fluent in English. If they had intended the right to keep and bear arms to apply only to the militia, they would have said so. They would have written "A well-regulated militia being necessary to the security of a free state, the right of the states to arm their respective militias shall not be infringed."

They didn't say that. The main sentence says "right of the people to keep and bear arms shall not be infringed." "People" means everybody, not just the members of the militia. The subordinate clause, "A well-regulated militia being necessary to the security of a free state," just gives one, but not the only, reason why all the people have a right to keep and bear arms. The militia, after all, was drawn from the people. It was not the Army. The first meaning of "bear," by the way, is to carry, bring or take. Americans have the right to keep arms and to carry them.

The word "regulate" in those days meant trained, and do you notice again the connection between arms and freedom? The subordinate clause refers to a "free state." Obviously, an unfree state would not allow the people to be armed.

The Founding Fathers were not urban neurotics like so many of today's politicians. They were almost all outdoor people. Guns were to them just tools, like their axes or plows. You couldn't survive in the wilderness without firearms, and at the time of our Revolution, there were only about 3 million people from Maine to Georgia.

Nor were there any police forces. There was no Secret Service, FBI or any of the other alphabet law-enforcement agencies. If you decided to travel, you traveled at your own risk, and you can bet people traveled armed. When I was last at Williamsburg, Va., they had a room in one of the historical houses arranged as if a traveler had just arrived and unpacked. There on top of a dresser was a pistol.