NCPA - National Center for Policy Analysis

So Young and So Many Pills

December 29, 2010

These days, the medicine cabinet is truly a family affair, says Anna Wilde Matthews in the Wall Street Journal.  More than a quarter of U.S. kids and teens are taking a medication on a chronic basis, according to Medco Health Solutions, Inc., the biggest U.S. pharmacy benefit manager.  Nearly 7 percent are on two or more such drugs, based on the company's database figures for 2008.

Many medications kids take on a regular basis are well known, including treatments for attention-deficit hyperactivity disorder.  But children and teens are also taking a wide variety of other medications once considered only to be for adults, from statins to diabetes pills and sleep drugs.  Prescriptions for antihypertensives in people up to age 19 could hit 5.5. million this year, up 17 percent since 2007.

Furthermore, in 2009:

  • 9.6 million antidepressant prescriptions were dispensed to children and teens 19 and under; more than one million of those went to children 9 years old and younger.
  • 5.2 million antihypertensives (blood pressure) prescriptions were dispensed to children and teens in the same age group; 1.8 million of these went to children 9 years and younger.
  • 6.5 million antipsychotics were prescribed to children and teens 19 and under; more than 1.3 million of those went to children 9 years and younger.

Researchers attribute the wide usage in part to doctors and parents becoming more aware of drugs as an option for kids. Unhealthy diets and lack of exercise among children, which can lead to hypertension, also fuel the use of some of these treatments.

Most medications that could be prescribed to children on a chronic basis haven't been tested specifically in kids, says Danny Benjamin, a Duke University pediatrics professor.  And older drugs rarely get examined, since pharmaceutical firms have little incentive to test medicines once they are no longer under patent protection.

Still, a growing number of studies have been done under a Food and Drug Administration program that rewards drug companies for testing medications in children.  In more than a third of these studies, there have been surprising side effects, or results that suggested a smaller or larger dose was needed than had been expected, Dr. Benjamin says.  

"We know we're making errors in dosing and safety," says Dr. Benjamin, who is leading a new National Institutes of Health initiative to study drugs in children. He suggests that parents should do as much research as they can to understand the evidence for the medicine, confirm the diagnosis, and identify side effects.

Source:  Anna Wilde Matthews, "So Young and So Many Pills," Wall Street Journal, December 28, 2010.

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