Add one more item to a child’s daily routine, in addition to schoolwork, soccer practice, guitar lessons, and play dates: a dose of medicine.

Prescription spending growth from 2008 to 2009 increased 10.8 percent, driven by a 5 percent increase in drug utilization and higher medication costs, according to the Medco 2010 Drug Trend Report. The growth in prescription drug use by children was nearly four times as high as in the overall population. That growth is even higher in adolescents (ages 10–19), with nearly 30 percent taking at least one prescription medication to treat a chronic condition. There were increases in the use of antipsychotics, diabetes medications, and asthma drugs.

What’s fueling the growth? One word — obesity. Many diseases that in the past were associated with adults are becoming more prevalent in children as obesity rates soar. The report says that health plans and insurers must develop disease prevention programs and adjust benefit strategies to effectively manage chronic and complex conditions in ever-younger populations. Medco says that as more children are diagnosed with adult diseases, spending on drugs and overall plan costs for young enrollees will increase.

“The fact that 1 in 3 adolescents is being treated for a chronic condition,” says Robert S. Epstein, MD, Medco’s chief medical officer, “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.”

Cost, utilization by age group

Source: Medco 2010 Drug Trend Report
*Trend is year-over-year net cost growth for the health plan.

Top four therapeutic categories for adolescent utilization

Endocrine — Diabetes medication utilization grew in patients younger than 19 by 5.3%.

Respiratory — Data analysis by age group revealed an inverse relationship between age and utilization: Utilization increased from 2008 to 2009 by 5% for patients younger than 19, but just 1% in patients over 65. Rising asthma rates probably account for increased use of respiratory medications in the young.

Antiviral — Utilization increased most in the youngest and oldest patients: 45.7% in patients younger than 19 and 10.3% in those over 65.

ADHD — Spending for those younger than 19 grew at approximately half the rate for adults ages 20–34 in 2009 from 2008 (18.9% versus 37.1%).

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