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When Americans Stop Taking Medicine


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Learn why Americans are not taken their prescription drugs and what happens to their diet and health as a consequnece

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When Americans Stop Taking Medicine

  1. 1. Why Americans stop taking their medicine…and what happens to the diet?
  2. 2. <ul><li>From a variety of sources including 2008 editorial in: </li></ul><ul><li>The New York Times </li></ul><ul><li>Washington Post’ </li></ul><ul><li>Economic Policy Institute </li></ul><ul><li>Kaiser Family Foundation </li></ul>Data compilation
  3. 3. Some facts <ul><li>Sales of Lipitor, the world’s leading prescription medicine were down 13% Q3 2008 </li></ul><ul><li>The number of prescriptions dispensed in the USA through Q3 08 were lower than the same period 2007 (IMS Health) </li></ul>
  4. 4. More facts <ul><li>“ if enough people try to save money by foregoing drugs, controllable conditions will escalate into major medical problems. That could eventually raise the nation’s total health care bill and lower the nation’s standard of living” </li></ul>
  5. 5. Hooked on drugs <ul><ul><li>The U.S. spends the highest $ for prescriptions in the world ($268.5 b – 07) equating to 10% of total health expenditures (U.S). </li></ul></ul><ul><li>From 1997-2007 # prescriptions filled increased 72% to 8.3 billion </li></ul><ul><li>Avg # prescriptions per person per year increased from 8.9 – 12.6 from 1997-2007. </li></ul><ul><li>Focus groups show that people are choosing to reduce medications (cut in half or skip days), or they choose to stop taking medications where they feel no effect. </li></ul><ul><li>You can feel the effects of pain medication, but not cholesterol medication </li></ul>
  6. 6. Why are we skipping drugs? <ul><li>Over prescription </li></ul><ul><li>Competing economic interests (gas, food) </li></ul><ul><li>Adverse publicity about certain drugs </li></ul><ul><li>Higher out of pocket co-pays </li></ul><ul><ul><li>Average co-pay for drugs on insurers “preferred” lists rose from $15 (00) to $25 (07) (Kaiser Family Foundation) </li></ul></ul><ul><ul><li>47m Americans without health insurance </li></ul></ul><ul><ul><li>Part D Medicare coverage donut hole </li></ul></ul><ul><ul><ul><li>Partial lack of coverage during any one year . Donut hole opens when a patient’s total drug costs exceed $2,510. Beneficiary must then absorb the next $3216 until total drug costs for the year reach $5,726 and then Medicare resumes. </li></ul></ul></ul>
  7. 7. The numbers <ul><ul><li>Decline in prescription-fill volume decline each consecutive month: June-Aug 08 </li></ul></ul><ul><li>Pfizer: Q3 08 vs Q3 07 $11.97 vs $11.99b </li></ul><ul><ul><li>Sales of lipitor and competitive drugs in generic market declined </li></ul></ul><ul><ul><li>Schering Plough: Q3 earnings dropped 23% on higher costs, but sales of Remicade (arthiritis drug) grew strongly </li></ul></ul><ul><ul><ul><li>Sales of cholesterol drug (portfolio) dropped 15% </li></ul></ul></ul>
  8. 8. How this plays out in the diet <ul><ul><li>Possible increase in emergency medical intervention. </li></ul></ul><ul><ul><ul><li>Emergency intervention circumvent nutrition care and long term nutrition counseling: drug therapy vs nutrition care) </li></ul></ul></ul><ul><ul><li>Economic situation drives lower quality food choices </li></ul></ul><ul><ul><ul><li>convenience/higher fat-sugar, lower cost foods in addition to poor prescription compliance aggravates conditions that can be managed through diet </li></ul></ul></ul>
  9. 9. How this plays out in the diet <ul><ul><li>Surge in assertions “diet doesn’t work” </li></ul></ul><ul><ul><ul><li>cholesterol levels, triglycerides, blood sugar and related clinical indicators point to poor dietary compliance, or poor results from dietary intervention. </li></ul></ul></ul><ul><ul><ul><li>But the precipitators could well be poor drug compliance secondary to economic stress </li></ul></ul></ul>
  10. 10. The economy in numbers <ul><li>9.5 m unemployed Jan 08 up from 7.5 m Jan 07 </li></ul><ul><li>Median weekly wages for FTE fell 1.6% in 2008 </li></ul><ul><li>Foreclosures in Sept 08 were 71% higher than Sept 07 </li></ul><ul><li>Sept 08 17.1 million underemployed workers vs 13 million in Sept 07 </li></ul><ul><li>$2 trillion in pension wealth has been lost </li></ul><ul><li>In Aug 2008 the trade deficit grew to 5% of national output versus 3.9% </li></ul>
  11. 11. Retirement: the next tsunami <ul><li># traditional pensions declined from > 100,000 to about 31,000 1980s-1990s. </li></ul><ul><li>Remaining plans still cover 44 million workers and retirees, a growing number of workers and families now have only retirement savings plans, such as 401(k)s, and other savings for retirement </li></ul><ul><li>In a 401(k) plan, there is no promised benefit; whatever is in the account at retirement is what the retiree gets. </li></ul><ul><li>In traditional pensions, benefits are promised and employers generally bear the burden of funding them. </li></ul><ul><li>In 1999 , 166 pension plans were underfunded by $50 million or more, and the total shortfall was $18.36 billion. </li></ul><ul><li>By 2002 , 1,058 plans were $ 305.88 billion underfunded. </li></ul><ul><li>When companies switch their underfunded pension plans to the government’s Pension Benefit Guaranty Corp, per person benefits are limited to a maximum of $45,614 for a retiree age 65 or older </li></ul><ul><li>For 20% of the nation’s elderly, social security is their sole source of retirement </li></ul>Source: Washington Post June 7, 2005/The Nation’s Plate (adapted)
  12. 12. December 11 2008 <ul><li>10% of Americans now receive food stamps </li></ul><ul><li>1/6 th of the population in West Virginia receives food stamp assistance </li></ul><ul><li>> 31.5 million Americans received food stamp benefits in September 08, the highest on record, surpassing an old record of 27.4 million in 1994. </li></ul>
  13. 13. When the fundamental needs of Americans go unmet <ul><li>There is no diet </li></ul>
  14. 14. <ul><li>Developed by Amanda Archibald, R.D. </li></ul><ul><li> coming Winter 2009 </li></ul>A Presentation from The Nation’s Plate