Declining Medicine Use and Costs: For Better or Worse?

It's clear the U.S. is in a state of flux. As implementation of the Affordable Care Act brings fundamental change to healthcare access, delivery systems and payment structures, the landscape will continue to change in the next 5 years and beyond. 

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In 2012, utilization of healthcare services declined nationally and contributed to a reduction in the overall cost of medicines. The drivers of these declines are many and complex and point to the paradox that while drug costs are actually falling for many patients, their exposure to healthcare costs is increasing. These issues are affecting patients differently depending on the type of insurance coverage they have, and which diseases they suffer from. Millions are paying less for medicines due to patent expiries, while others with rare diseases may be able to use transformative and breakthrough medicines, but may also be exposed to very high costs for those treatments.

Key Findings

Fewer patients made office visits, while ER visits increased

  • The lowest-cost medical interventions are visits to doctors' offices, which continued to decline in 2012, though much more slowly than the prior two years.
  • Non-emergency hospital admissions declined again in 2012, though also more slowly.
  • Outpatient treatment also declined.
  • Patient admissions to hospitals via emergency departments are relatively small in number, but increased at a dramatically higher rate in the last two years, driven by increased ER visits from the insured population.

Patients’ use of medicines declined by 0.1% in 2012, driven by the largest population group, adults aged 26-49

  • Americans’ use of medicines per person declined by 0.1% in 2012, up from 2011 when usage declined by 1.1%.
  • Seniors remained the largest users of medicines with those over 50 using 64% of prescriptions, while only making up 33% of the population.
  • The cough, cold and flu season from November 2011 to April 2012 was weaker than in the previous year contributing the most to the lower per capita usage of medicines.
  • The use of prescriptions by 19-25 year olds declined slightly in 2012.
  • Changes in per capita use of prescription drugs could indicate either appropriate disease management or concerning trends in self-rationing by patients and could contribute positively or negatively to healthcare cost trends in the future.

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