Thursday, October 22, 2009

The things patients bring in

My favorite patient encounters almost always involve the patient bringing in something they found in a newspaper or magazine. The best ones are fully annotated with the patients thoughts and comments. Typical subjects are: alternative medicine, vitamins, noni juice (don't get me started), new tests or scare mongering articles about drugs I have prescribed.

The other day one of my patients brought in a list of the 50 most prescribed medications according to the AARP. Jackpot.

I have transcribed the data into excel so I could abstract some of the data. The raw excel file is here.

I have three charts from the excel file that are interesting, the first is just a graph of the number of prescriptions with the retail cost overlaid. Can you spot the brand name drugs:

I then simplified the data by removing the noise from the individual drugs and used the indications for each drug. Here is that data by number of prescriptions and then by cost:

You can see the disruption caused by the brand name drugs which catapult PPI (ulcer/heart burn medications) from 5% of the prescriptions to 17% of the cost and take statins (cholesterol) from 9% of the prescriptions to 18% of the cost. Can you imagine how the chart looked before Zocor (simvastatin) went generic?

There are no insulins on the list, so I wonder if there other absences.

What does it say about the U.S. that 3 of the top 6 indications for therapy are pain, depression and anxiety?
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