Americans who visited a doctor's office in 1999 were far more likely to receive more than one drug than US patients were in 1985, a new government study of physicians shows. The increasing reliance on prescription medicines spanned all ages of patients and almost all classes of drugs, with the notable exception of antibiotics.

About 66% of visits to doctors in 1999 resulted in patients receiving medicine or a vaccine compared with 61% in 1985. But those given prescriptions-especially the elderly, were much more likely to get multiple drugs, said Catherine W Burt, chief of the ambulatory case statistics branch at the National Centre for Health Statistics which conducted the survey.

The increase in prescribing 'is just alot more than we would have expected just from the aging of the population' Burt said.

The surveys findings suggest that drug advertising, including the promotion of drugs directly to the public, may be contributing to the trend.

The ones that are heavily marketed are, in fact, heavily prescribed, Burt said.

Direct to consumer advertising has made a huge impact on sales of medications which are not always the best medications for people to take.

Spending for prescription drugs is the fastest growing category of health care expenditures.

It is a major political issue for the Bush administration which has proposed reducing drug costs for the elderly under the federal Medicare program as well as a concern for employers and other consumers facing rising health costs.

The new information comes from a survey of a representative national sample of office based physicians. It shows that medication (usually a prescription) was provided at 501 million of more than 756 million visits to the doctor that Americans made during 1999.

The survey asked doctors how many drugs, and which ones were prescribed or recommended during visits. In 1999 146 drugs were prescribed per 100 visits, a 33% increase over the 1985 figure of 109 drugs per 100 visits.

Drugs to treat heart, circulatory and kidney diseases were the top category. But the most frequently prescribed drug, Claritin, is for allergy symptoms. Also among the top 10 were Lipitor, a cholesterol lowering medicine; Prilosec, a drug for heartburn and for stomach and duodenal ulcers; and Celebrex, a new drug for arthritis

The survey examined the use of 104 drugs approved by the Food and Drug Administration between 1997 and 1999  and found evidence suggesting that marketing was closely related to frequency of prescribing.

Drugs that were heavily advertised were much more likely than others to be in the top 20% of new drugs prescribed. It found that four new drugs-Celebrex and Vioxx for arthritis, Singulair for asthma and Detrol for overactive bladder accounted for 12% of the estimated 17 billion dollar increase in drug spending that occurred between 1998 and 1999.

Manufacturers spend money on promotion to the extent that they believe that there's a good market, said Nancy M Ostrove, deputy director of the FDA's division of drug marketing, advertising and communication. She said it is impossible to say whether advertising causes prescribing or whether increases in both are driven by consumer demand.

Burt said antibiotic prescribing declined by 14% in 19909 compared with 1985-potentially good news because overprescribing of antibiotics for infections that do not require them has been a factor in the rise of bacteria resistant to the drugs.

Washingtom Post July 18, 2001.

Dr Mercola's Comment:

Marketing works, no question about it.

Drug companies are not stupid. They have been able to change the rules so they can now market to consumers directly.

It is no wonder why 2/3 of doctor visits resulted in drugs being prescribed.

This is one of the main reasons why spending on prescription drugs is the fastest growing category of health care expenditure.

It is also one of the major contributing factors why physicians are the third leading cause of death in the US, as they have an over reliance on using drugs as Band Aids rather than seeking the cause of the problem.