Consider an average classroom with twenty adolescents in it, and chances are, about six of them are on at least one medication to treat a chronic condition. Thirty percent of adolescents are being treated with pharmaceuticals for conditions like type 2 diabetes, asthma, and mental health issues.
Over the years that we’ve been working with individual health insurance policies, we’ve seen a trend towards more out of pocket expenses for prescription drugs. Policies that used to offer copays right away now have prescription deductibles of at least a few hundred dollars before the copays begin (which means that the insured pays the entire cost of the drugs until the deductible is met). Other policies have switched to generic-only coverage for drugs. Some policies, including a lot of popular HSA qualified plans, count prescriptions towards the overall deductible – which can be several thousand dollars – and only pay for them after the deductible is met. Just about every individual policy in Colorado now has less coverage for prescriptions than it did ten years ago.
Out of pocket expenses for prescriptions have increased specifically because of the dramatically increased utilization of pharmaceutical treatments. And not all of that utilization is necessary. Some of it is doing more harm than good. While it’s true that diseases like type 2 diabetes have to be treated, they could be prevented by improving access to proper diets and adequate exercise. And the use of anti-psychotic medications has been linked to the development of type 2 diabetes, so it would appear that we’re creating our own vicious circle here.
The thought of 30 percent of adolescents being on medication for chronic conditions should make us all sit up and take notice. Hopefully it will fuel the cry for better school lunches and increased attention to prevention of obesity and mental health problems in kids. As a society, we simply cannot afford to continue to increase our utilization of prescription drugs.
David Williams’ article was featured in the 4th anniversary edition of the Cavalcade of Risk this week.