dlake02

I need to ask this, and I dare not ask on our internal email alias...

Our company provides a very good medical benefit - well, very poor by developed-world standards, but good for the US.

But, the "co-pay" for "Prescription medicines" has just gone up from $30 to $80. Per prescription for up to 90-days supply.

Big deal, I thought - not really going to affect anyone.

WRONG !!!! Our email list lit up with people complaining that they were going through $240 in co-pay a month now as opposed to $90, 12 months a year.

My conclusion is that Americans appear to be taking too many medications, at least, those that can afford it. I would expect to see between 3-5% of people on some kind of prescription medication at any one time; rough calculations (very non-scientific) from our email list shows around 60% of OUR population are being medicated for something-or-other.

Obviously, this is per family and families tend to be bigger here (sweeping generalisation), but even so, this is a hell of a lot of medicine.

So, do I work with a sickly bunch of people that really should have been put out to pasture years ago, or is this normal for those that have insurance ?

Educate me please....

Speedwell

OK, now unless you are a doctor or medical professional, you are not qualified to diagnose other people or judge how they manage their diagnoses.

Yes, it seems shocking how many people have a diagnosis they manage with medication. It does seem like doctors like throwing pills at people in an attempt to do something other than fully investigate an illness. It does seem that many people go to the doctor expecting to walk out with a prescription, or they don't feel helped. In the US doctors are so afraid of undertreating a patient and being held liable for it that they may overprescribe. Also doctors often don't trust patients to follow up on lifestyle changes.

I discussed this issue with my doctor once and she said that doctors now know how to diagnose many things that were chalked up to "getting older" or "being overworked". Common illnesses such as type 2 diabetes are getting diagnosed more often because new diagnostic thresholds are lower (for example, a normal fasting blood sugar is now considered 100 in the US rather than 110). Things for which there used to be no good treatment, such as mild depression, now have relatively safe medications that were developed in the past 10 years. The population as a whole is aging and needing more medical assistance.

Getting "put out to pasture" is not an option in the US because our support system for the ill and disabled is so bad or nonexistent.

It has less to do with insurance or hypochondria than it does with a better understanding of illness and better availability of treatment. Congratulations on staying healthy.

Pulaski

What you see is likely very normal (normal for the US, that is), and many of the prescriptions are for drugs to treat the side effects of other drugs - including but not confined to water retention, constipation, insomnia, risk of blood clots, and depression.

My FIL started on blood pressure medication in his 30's, and has been on it ever since, but has steadily been prescribed other long term meds along the way. I think he currently has about 6 ongoing prescriptions! He has a family history of heart attacks, but even so I doubt that he truely needs all the drugs he is being prescribed.

Someone else I visit, and know fairly well, is on disability welfare and so funded entirely by the government has somewhere around 30 (thirty ) prescriptions! Some are certainly medically necessary, but many have been prescribed to treat side effects of other drugs. She carries them around in a grocery bag, and I'd estimate the chances of her taking the prescribed doses of every drug on the correct schedule as approximately zero.

Someone else I used to know, an apparently healthy albeit slightly overweight woman in her late 20's, moved out of her rented home leaving behind several prescription drugs, around 5 or 6 if I remember correctly (it was certainly several together in a kitchen cupboard), .... and the very fact she left them behind tells you how essential they were!

Englishtart

I think you have to be careful not to generalize on this subject. I have been going to the same family practise here in N Charleston for the last 18 months or so and have actually never seen my actual Dr, always see the Nurse practitioner, hubby too.
She has a great attitude about prescribing meds, knowing how much the co-pays can cost (between $5 and $50 for us for 30 days) She will if possible, give us a name of an over the counter med that will work just as well, that we can get cheaper. This has been new to us, most other practises have just written out scripts without any regard for patient costs.
Also, it is up to you to let your pharmacy know that you are willing to take a generic brand if available, they are usually a lot cheaper than name brand meds. I guess it all depends on where you go and who you see....

dlake02

Wow ! That is NOT a great attitude.... I've always come from the view that 90% of people need no medication of any sort 90% of the time.

Here it seems those that have insurance are using it as if it were a pot of cash to be used for as many drugs as possible rather than insurance in case you are actually ill.

Michael

Something is wrong with your plan. Over 90% of the drugs that people take are generic with at least 50% of those retail at about $4 for a 30 days supply and many of the remainder of the generic drugs are not a lot more and are cheaper per pill in higher dosages and 90 day quantities and many can be split making the drug even cheaper.

For example Simvastatin, the most common cholesterol drug, at 5 mg is $4.99 for a 30 day supply at Costco with a coupon but a 90 day supply is only $8.49 without a coupon and is $9.95 for a 90 day supply of 40 mg tablets. Therefore if a person needs 20 mg per day and purchases a 90 day supply of the 40 mg tablets and splits them, the cost is $1.66 per 30 day supply (cheaper than aspirin).

On the other hand, the brand name (Zocor) is about 100 times more expensive.

http://www.goodrx.com/price/simvasta...l__simvastatin

It seems that the only time it would be worth using your prescription drug plan would be if a generic drug was not available and you had to purchase brand name drugs.

Many older people need cholesterol and/or high blood pressure drugs and the vast majority are very inexpensive generic drugs.

Pulaski

SultanOfSwing

It appears to be a two-edged sword. My wife and I both take blood pressure medication and my doctor has told me that even if I weren't a fatty I'd still need it (family history). I also have to take a pill to keep my uric acid down or else I get the most awful attacks of gout in my ankles and feet. I only take those because I have to though, do you think I want to be taking those pills at 34? Do I f*** - but it's better to take the allopurinol than to not be able to put a sock on my foot for two weeks

On the other hand though, and this is 100% anecdotal, I do think the US system does seem to promote some form of hypochondria that I never observed back home. As I say, this is based on observation but I swear there is one friend of my wife who fills FB with her first world problems who seems to think 'having a bad morning' is a medical condition and posts about needing to see the doctor every three minutes. Not sure about over-medicated but there are a lot of people keeping the doctors busy, that's for sure

Me, I did everything I could not to go to the doctor because I'm tighter than a gnat's chuff, but I went to get the pain in my foot checked out, he took my BP as it was my first visit and before I turn around I was medicated up to the eyeballs. Just my luck the bloody generic BP meds didn't work either.

Michael

High blood pressure is genetic for men on my father's side of the family. 4 of his 5 brothers (including him) died of heart attacks (the youngest at 57) so it runs in the family. Two of my brothers had to start taking blood pressure drugs in their 30's and I had to start in my 50's. My youngest brother didn't like going to the doctor so he never knew that he had high blood pressure and had a heart attack when he was 52 and a stroke at 53 but he survived both but ended up being disabled due to short term memory loss.

SultanOfSwing

I never liked going to the doctor either, even though I knew I'd have some kind of BP problem, since every time I used our little monitor at home it was through the roof

sir_eccles

To a certain extent Americans have the attitude that because they pay so much for health insurance they should "get something back " so to speak. So tend to go more frequently. Whereas Brits don't want to trouble the Dr he's probably too busy besides it's only a flesh wound...

Don't forget most women may be on birth control so that's one scrip right away for most families.

Giantaxe

Yeh, although I do think that there is some over-medication in the US (France is far worse, btw) there's some over-generalization going on by the OP. Very easy for a family to have three or more prescriptions, say for birth control, a statin, and a prescription for eczema for a child etc. Myself, I have two prescriptions - one the statin that Michael mentions now costs next to nothing in generic form - and don't consider myself over-medicated.

Yorkieabroad

And yet in a recent thread when I mentioned that 2/3 of our cub pack filled in medical forms showing that they had allergies, asthma or were on meds for something your repsonse was "Nope, they didn't".

2/3 is pretty darn close to 60%, so maybe now you will accept that perhaps they did?

In fact, given that my figures included allergies for which regular medication wouldn't be taken, the cub pack figures look low compared to your population.

Sally Redux

It's an industry. Just look at the palaver around childbirth.

Michael

IMO, the biggest over medication are AHDH drugs (ritalin and adderall) which they seem to give out like candy to children but if an adult really needs then, it is difficult to find a doctor that will prescribe them. On the other hand, narcotics (eg. codeine) or benzodiazepines (eg. Klonopin) are very hard to get prescribed except for short terms.